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Home My WebLink AboutBLDE-22-006152 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-006152 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:4/26/2022 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) 87 OLD MAIN ST Owner or Tenant ANDERSON JOHN Telephone No. Owner's Address 200 SWANTON ST, WINCHESTER, MA 01890 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: Miscellaneous work per attached. 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 KVA 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 Heat Pump Number _ Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: MICHAEL P YOUNG Licensee: Michael P Young Signature LIC.NO.: 37999 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 156 CAPES TRL,WEST BARNSTABLE MA 02668 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: $75.00 _ { RECEIVED 1 T Commonwealth./�fada APR 2 2 202E Official Use Only .14 ,$ `� c� UILDlNG DEPAR—t�S TtIVo. rr2Z spartmsnf o� }irs Jylvfcsd ✓ BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked [Rev. 1/07) (leave blank)C�+/► _ Q APPLICATION FOR PERMIT TO PERFORM ELECTR W All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 CM 12.00 rY�RK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of: v Date: � By this application the undersigned ivYn iceARof his OUTHintention to perform the electr To the Ins ic of rk dYr ibed below. Location(Street&Number) ow. Owner or Tenant e4ti. Xy,i./., 4 U,,,....) Owner's Address Ph e No. / /� Lyls2,A.: S Is this permit In conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Auth rization No. Existing Service L> Amps ,lG, G '� _ S p Volts Overhead New �Ce Und grd E No.of Meters Amps / Volts Overhead❑ Und rd Number of Feeders and Ampacity g El No.of Meters Location and Nature of Proposed Electrical Work: 4./0'4' / .v dsk/�,, �i ' •11- ZtUily/ .Z.a/ G,I+i-4 •11 ' j f i kri ,yfiv om.letion o the ollowin,table m be waived b the Inspector o Wires. ,Qi No.of Recessed Luminaires ... No.of Ceil:Susp.(Paddle)Fans °•° ota t No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA �t" No.of Luminaires Swimming Pool , ,r o e ❑ ❑ mergency g mg'',-,,2 No.of Receptacle Outlets 'n°d• B tte Units No.of Oil Burners FIRE ALARMS No.of Zones : No.of Switches No.of Gas Burners 'o.o etec on an No.of Ranges Initiatin: Devices No.of Air Cond. ota Tons No.of Alerting Devices No.of Waste Disposers 'eat 'ump `um s er ons ' " Totals: Det etion/Alertin pDevices No.of Dishwashers Space/Area Heating KW Local 0 un crpa No.of Dryers Heating Appliances .ecu Connection ❑ Other `o.o "a er KW ty ystems: Heaters KW �o.° `o.o No.of Devices or E s uivalent Si ns Ballasts Data Wiring: No.of Devices or Es uivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommun ca ons " ring: OTHER: No.of Devices or E s uivalent Attach additional detail if desired,or as required by the Inspector of Wires, Estimated Value of Electrical Work: Work to Start: (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVEAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insu including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such c vera s in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER I certify,under the p ins and p 0 (Specify:) ties of perjury,that a information on this application is true and complete. FIRM NAME: e,.-Zi�. . `' j L Licensee: • , / LIC.NO.: ,� 9�yG YQ • ft. — Signature --- ------ (lf applicable,enter"exempt in th ice a number line.) LIC.NO.: Address: —S G. L. .6,`4 Bus.Tel.No.• 2`7� �� *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.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/Agent ❑owner • owner's a.ent. Signature Telephone No. PERMIT FEE:$