BLDE-22-006462 , c--1-;\ Commonwealth of Official Use Only
�, Massachusetts Permit No. BLDE-22-006462
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.1/07]
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:5/10/2022
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 76 SOUTH SHORE DR
Owner or Tenant JOYCE MARTIN J TRS Telephone No.
Owner's Address JOYCE ELIZABETH TRS, 135 ACADEMY AVE,WEYMOUTH, MA 02188-4203
Is this permit in conjunction with a building permit? Yes 0 No 0 ( I)
Purpose of Building
Utility Authorization
Existing Service 60 Amps Volts Overhead 0 Undgrd -
New Service 200 Amps Volts Overhead 0 Undgrd Cl No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Upgrade service.
Completion of the following table may be waived by the Inspector of Wires.
No.of Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting
No.of Luminaires grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Gas Burners No.of Detection and
No.of Switches Initiatine Devices
No.of Air Cond. Total No.of Alerting Devices
No.of Ranges Tons
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers Totals: Detection/Alerting Devices
❑ Municipal ❑ Other:
No.of Dishwashers Space/Area Heating KW Local Connection
Security Systems:*
No.of Dryers Heating Appliances KW No.of Devices or Equivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Signs No.of Devices or Equivalent
•
Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides
proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage
is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: MICHAEL YOUNG LIC.NO.: 22314
Licensee: MICHAEL YOUNG Signature
Bus.Tel.No.:
(If applicable,enter"exempt"in the license number line.) Alt.Tel.No.:
Address: 156 CAPES TRL,WEST BARNSTABLE MA 02668
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License:
OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But my
signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent.
Owner/Agent I PERMIT FEE: $50.00 I
Signature Telephone No.
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RECEIVE ®
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APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: S79`2 a
City or Town of: YARMOUTH To the Ins ecto ofWires:
By this application the undersigned gives notice of his or her intention to perform the e e electrical o k described below.
Location(Street&Number) 1p sAv j SA j 1)D, v�
Owner or Tenant f. • � L� 7V
N.
C �l Telephone No. 7 99%'c 1fO(
i Owner's Address 2.6 faj J he,e A/t tJ&
N Is this permit in conjunction with a building permit? Yes ElNo El (Check Appropriate Box)
Purpose of Building Utility Authorization No. 29 7 J j d lV V
Existing Service%G Amps />U/ 4)k6Volts Overhead Er.---Undgrd❑ No.of Meters /
New Service c Amps /,.20/cikj Volts Overhead!'� Undgrd ❑ No.of Meters /
kNumber of Feeders and Ampacity
i Location and Nature of Proposed Electrical Work: t ye: v/( , Ch
NA
4r1 Completion of the followingtable m-be waived by the Inspector of Wires.
U. No.of Recessed Luminaires No.of Cell.-Sus No.of Total
�,t p.(Paddle)Fans Transformers KVA
.i No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Wit;° No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting
grnd. grnd. ❑ Battery Units
`` No.of Receptacle Outlets No.of Oil Burners
•;y FIRE ALARMS INo.of Zones
No.of Switches No.of Gas Burners No.of Detection and
l r` No.of Ranges Total Initiating Devices
No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number Tons IR�� No.of Seii=Contained
Totals: ...................
"""'"""""""' Detection/Alertin Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal
Connection ❑ Other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.ofNo.of Devices or Equivalent
Heaters KW No.°f Data Wiring:
Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER: •
Attach additional detail if desired,or as required by the Inspector of Wires,
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such covers force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:)
I certify,under the ns and pent s of perjury,that th formation on this application is true and complete.
FIRM NAME: Du A% ei /Cr J./ C LIC.NO.: c✓?3/9","
jj
Licensee: /' ,7. yttj(3-- Signature LIC.NO.:,77 f 9 (
(If applicable,enf er"exem. "in t e license number line.)
Address: ! 67 '/6`c i9t-i Z $1 � �y� Bus.TeL No.: 77 c/_ a�y4�
Alt.
*Per M.G.L.c. 147,s. 7-.1,security work requires Department of Public Safety"S"License: c.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE:$