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Home My WebLink AboutBLDE-22-004191 Commonwealth of Official Use Only "' r e{ Massachusetts Permit No. BLDE-22-004191 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:1/27/2022 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 elecmcal work described below. Location(Street&Number) 11 WINCHESTER AVE Owner or Tenant Mike Kelley Telephone No. Owner's Address 11 WINCHESTER AVENUE,WEST YARMOUTH,MA 02673 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 N:oak ters New Service Amps Volts Overhead 0 Undgrd 0 ;\\�isM.of Number of Feeders and Ampacity ? Q Location and Nature of Proposed Electrical Work: Replacement furnace&water heater. .e ~ //////�� C Completion of the following table be The btep of Wires. Na.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of V Transformers rtti/` ,tom'' Na.of Luminaire Outlets No.of Hot Tubs Generators �j I - �ry,� No.of Luminaires Swimming Pool Above ❑ Tn- ❑ No.of Emergency Ligh in ,` grnd. grnd. Battery Units G No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:' No.of Devices or Equivalent No.of Water 1 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 YOUNG Licensee: MICHAEL YOUNG Signature LIC.NO.: 22314 (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:$50.00 p- 2/fO/VL ICg, RECEIVED , O' \ -)7 PT JAN 2 6 2022 BUILDING uL-AF `AIEN1 Commomwaa��ff y�j [th of/l/a6eachaerlld Official Use Only , "r,ZLi 2 '_B'' p�, s Permit No. ( � c_.. ;AG; rparlmrnl o uro Serviced ;1I� 'r Occupancy and Fee Checked ss i BOARD OF FIRE PREVENTION REGULATIONS [Rev, 1/07] (leave blank) Ls. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC,527 C R 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / ,2 !� ) City or Town of: YARMOUTH To the Inspe or of ir•es: ; By this application the undersigned gives notice of his orl her intention to perform the electrical work desecibed below. Location(Street&Number) // bJi n/�' /ly 5f r , / tit 1i G/ Si U/min./,1 Owner or Tenant �/ f6Jl ,,, 1/ Telephone No. 7'7 4-/— 7 74 N. �•! Owner's Address // I //VCr L S'� c"- 4 A /2/l�S 7' 7,/}7f iYLC.2.?�L _ 7r �� 1Is this permit in conjunction with a building permit? Yes ❑ No j' ( k Appropriate Box) ,,,'s 1 Purpose of Building Utility Authorization No. r •. Existing Service ru Amps /,2c /.21v't) Volts Overhead El--- Undgrd E No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters N. Number of Feeders and Ampacity Location and Nature of Pro Li! posed Ele rical Work: -i.,.j A../ "i Completion of the followin table may be waived by the Inspector of Wires. 1.1. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of iota! _! Transformers KVA r a No.of Luminaire Outlets No.of Hot Tubs Generators KVA r.:\ st No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting irnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners o.of Detection and Initiating Devices _ ' No.of Ranges No.of Air Cond. Total No.of Alerting Devices 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❑ CoMunicipnnectioal n ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of Data Wiring: Heaters 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 insu including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such covera ' in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) I certify,under the ns and penah'es of perjury,that the 71rmarIon on this application is true and complete. FIRM NAME: e u aJ_ I r J ' LIC.NO.: ;•I 3/yA Licensee: /'/i e/i,yt,L //J.JA/( Signature --� 7' G / __LIC.NO.:�p99(If applicable,en er"exemyyt"in the nse number r line.) �� ry Address: f 3 (- �/ hJ .� , Bus.Tel.No.;`77 f Yf y- 7 %� �L"S "lfl-t L �� i / 5 Alt.Tel.No.: *Per M.G.L.c. 147,s.57- 1,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 insurance 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 Signature Telephone No. ( PERMIT FEE: $ ,5() - • •."1.- ,)'s ' • .• - • • • pt,4140101k% • • rAtt 01. ": --VOL •if • _ _