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Home My WebLink AboutBLDE-19-001512 !t Commonwealth of OfficiaL Use Only ft Massachusetts Permit No. BLDE-19-001512 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked f Rev.l/071 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEA SE PRINT ININK OR TYPE ALL INFORMATION) Date:9/13/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of ms or her intention to pertorm the electrical work described below. Location(Street&Number) 121 ROUTE 6A Owner or Tenant CAPE COD CO-OPERATIVE BANK Telephone No. Owner's Address THE COOPERATIVE BANK OF CAPE COD, PO BOX 34781,BETHESDA,MD 20827 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement boiler. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ce1L-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 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 ❑ Municipal ❑ Other: Connection No,of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW 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: 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete.. FIRM NAME: Richard A Haarman Licensee: Richard A Haarman Signature LIC.NO.: 13615 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 18 Holmes Rd,Harwich MA 026452219 Mt.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 signature below,I hereby waive this requirement.I am the(check one) In owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$80.00 oft, 4(e3/fe teg- i Iv S l.ommoruura oil Official Use Only _- meq- s'i7� 1,_, cc�� cc77 Permit No. Vapartment o�Jitr-Serviced BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checkedv. 1/07] ' (leave blank) ) APPLICATION FOR�PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC)) 527 CMR 12.00 . (PLEASE PRINT IN INK ORTYPE ALL INFORMATION Date: 9117118 City or Town of: YARMOUTH To the Inspector of Wires: • w \ By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) d 1 'R} 6 r9 mN a Owner'orTenant Me �y 4 ,vL 'EMI It Telephone No. D CV o Owner's Address 1 -q1V o- i Is this permit in conjunction with a building permit? Yes No l /1 ❑ t�l (Check Appropriate Box) fa o \ urpose of Building CONN./tell-0 �3ciMlt Utility Authorization No. Existing Service cV Amps y p I'jUl,�f�$ Volts Overhead 0 Undgrd❑' No.of Meters ( -f___._.-.-^-- ew Service Amps / Volts Overhead❑ Undgrd 0 No,of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: `f`)W'2. 'NW Completion of thefollowing/able may be waived by the Inspector of Wires. 1 No.of Recessed Luminaires No.of CeiL-Busy.(Paddle)Fans • No.of Total Transformers KVA t1 No.of Luminaire Outlets No.'of Hot Tubs Generators KVA IJV • No.of Luminaires Swimming Pool Above In- No.of Lmergency Lighting - grnd. grnd. 0 Battery Units - e No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and • Initiating Devices tv No.of Ranges No.of Air Cond. Too No.of Alerting Devices 1 No,of Waste Disposers Heat Pump Number No.of Self-Contained - yV Totals:I 'Tons KW Detection/Alerting Devices _-.- No.of Dishwashers Space/Area HeatingKW Munlci Loca10 Connection 0 Other f No.of Dryers Heating Appliances KVV Security Systems:" No.of Water No.of Devices or Equivalent No.of No.of S Heaters Signs Ballasts Data Wiring: No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: Na.of Devices or Equivalent OTHER: • P' Attach additional detail if desired or as required by the Inspector of Wires. S Estimated Value o EI trical Work: (When required by municipal policy.) Work to Start: 10 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VERAGE: 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 Et BOND 0 OTHER 0 (Specify:) I certify, under the coins and penalties of erl ry,that the information on this application is true and complete, FIRM NAME: 144/47. WN ate *IC. .CYC L LIC.NO.: IS n J Licensee: ' ' �,C v a• ► h .1 .0(1l� Signaturez-K LIC.NO.: I � pfapplirnbfe, r"amp "i rhe license numb !' e.) Addresr. I /\01 Ji \ KI ) r nd i mg 0Z6 Bus.Tel.No: a ,••I Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie No. �lU - 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)0 owner 0 owner's agent 1 Owner/Agent Signature Telephone No. I PERMIT FEE: $ g�