HomeMy WebLinkAboutBLDE-22-007441 r.. Commonwealth of Official Use Only
%..)).
44.
Massachusetts Permit No. BLDE-22-007441
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:6/28/2022
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) 2 CAPT PERCIVAL RD
Owner or Tenant Matt Scarborough Telephone No.
Owner's Address 2 CAPT PERCIVAL RD, SOUTH YARMOUTH, MA 02664
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters
New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install generator ,
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators 1 KVA 18
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
. Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Signs 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: 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: Robert A Young
Licensee: Robert A Young Signature LIC.NO.: 10833
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:220 HIGH ST,REAR,TAUNTON MA 027803540 Alt.Tel.No.:
*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
Signature Telephone No. PERMIT FEE: $50.00
Commonwealg of Maddachulett6 fficial Us Only
1 t � (
_„� cc/�� cc�� Permit No. Z. ���
si 2epartmeni of ire-Cervical
-- _ Occu anc and Fee Checked
-- BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07 y
•4�� (leave blank)
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: Co ( M f X.A.
City or Town of: \(UVV1notA*i N 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) a. C.ek°Ay PAY'`xvckk 4•
Owner or Tenant IN,Nc'�'" CO,:v-1,00 VI)(-4- -x Telephone No. 5O'g• (o1'a.•'73. io
Owner's Address S C W'
Is this permit in conjunction with a building permit? Yes n No g (Check Appropriate Box)
Purpose of Building R dew -ak Utility Authorization No.
Existing Service Amps / Volts Overhead n Undgrd n No.of Meters
New Service Amps / Volts Overhead Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: FtAv- t%s i l vt5.1-c.V\ c AcA \Nw .- aif K kW
0 C�C',V1Q �v`'
LI Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators k KVA ,B
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
t
0) No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
of Detection and
OJ No.of Switches No.of Gas Burners No. Initiating Devices
Tota
S' ` No.of Ranges No.of Air Cond. Tonsl No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number Tons KW No.of Self-Contained
',Tons
Detection/Alerting Devices
`7" No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other
4,f Connectien
No.of Dryers Heating Appliances KW Security Systems:
No.of Water No.of No.of No.of Devices:,r Equivalent
Heaters KW Ballasts Data Wiring:
Signs 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 coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ✓❑ BOND ❑ OTHER ❑ (Specify:) Expires 4/13/
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Young Electrical Svc. Inc. i",... f��i a LJC.NO.: A10833
Licensee: Robert A. Young Signature )2 '),C..1%J,,,..- `� LIC.NO.: 24869-E
(If applicable, enter "exempt"in the license number line.)
us.Tel.No.: 508-823-0279
Address: 220 Hiah Street- Rear Taunton. MA 02780
-Alt.Tel.No.:
*Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurancc coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent.
Owner/Agent PERMIT FEE: $ 5 C — J
Signature Telephone No.