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Home My WebLink AboutBLDE-18-001769 Commonwealth of Official Use Only �� . 'i►� Massachusetts Permit No. BLDE-18-001769 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.1/071 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:9/26/2017 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) 17 BURNABY ST Owner or Tenant SIMEONE GARY M Telephone No. Owner's Address SIMEONE SUSAN M,PO BOX 442,WEST BROOKFIELD,MA 01585-0442 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check ropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No New Service Amps Volts Overhead 0 Undgrd ❑ o. e s .., Number of Feeders and Ampacity ~ Location and Nature of Proposed Electrical Work: Replacement furnace /1/1 `�� Completion of the following table may be wan, t , r of ares. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of ti 1 Transformers A 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 TonsCI No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained `r 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 Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs. No.of Motors Total IIP 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 E Bowdoin Licensee: Robert E Bowdoin Signature LIC.NO.: 51981 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:502 PITCHERS WAY, HYANNIS MA 026012582 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 signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. - ` Owner/Agent _ Signature , r Telephone No. PERMIT FEE:$50.00 6',(Z 140(3(17 AM- 2/ (;e ...e.", winnonweassos Of isSISIRRICMikteliS --——, _r_„y Department of Fire Services Permit No. g--1 1 ( c VIE!' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.111991 (leave dant) \�� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK \ An work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR l2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: q� I7 City or Town of: (I1CJ+ Ifirartiuth 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(Sheet dr Number) I i Pk)rn 104 S'hec ti— OwnerorTenant A S < 1( , 4eta . Telephone No. Owner's Address Is this permit 1A conjunction with a budding permit, Yes 0 No 0 (Check Appropriate Box) Purpose°Mending g Uti it'y Authorization No. Erdsttng Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Amps / Volts Overhead 0 Undgrd❑ No.of Meters j ofFeeders and Atomicity i 91,..- _ and Nature of Proposed Ekehieal Work: mg()ate i-e p I m it-- — , C.0 W= c - Con de don ofel6UOWEtg le nn76ehupaaror waivedby the m6of Wins. t_,l 1, ty o: Recessed Fixtures No.otCellrSunp.(Paddle)Fens o. otal TransformnE KVA ) -N 40, r,,.. Outlets No.of Hot Tubs Geometria KVA Cd 1 iFbf ,a,dug FirturesAbove In- Swimming F001 ❑ _ ❑ Ngo Ute, y °tiog No.of Receptacle Outlets No.of Oil Bunters FIRE ALARMS No.of Zones No.of Switches \ No.of Gas Stoners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total � No.ofAletingDevices No.of Waste Disposers Heat PompNumber TaIns KW No.of Self-Contained Totals_I I Detection/MerthTDevices No.of Dthwasben Space/AreaHeating KW Local 0 yst 0 Other No.of Dryers HeatingAppliancea HW Scantly vices or Equivalent No.of Water No.of No.of Data Whiny Heaters KWSigns Ballasts No.of Devices or Equivalent No.HpL --- v Bathtubs No.of Motors Total HP Telecommun'catiomVi'aiag: No.o DetkesorFgmvalent OTHER Attach additional detail Ifdesired,or as required by the Inspector of Wires. 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 ineludng"completed operation"coverage or its substantial equivalent. The undersigned certifies that such wlic age is in force,and has exhibited proof of same to the permit issuing Se. CHECK ONE INSURANCE BOND 0 OTHER 0 (Specify_) (Expiration Date) Estimated Value of epi W IU (When required by municipal policy.) Work to Start 01 Inspections to be requested in accordance with MEC Rule 10,and upon completion- /.cciif y,under the pans and penalties of perjury,that the informatiott on is tine and complete. FIRM NAME: Q,di'X�44 E3t4 &rxotlo/i... R LIC.NO.: License=¶dQa} • ttActoe In S LIC.NO.: Mgt(C (tfapprunb4,,cuterd e - re I' J Ras.TeL N Address: U l ',vas Ak.TeL 4ig-v lb-7 OWNER'S INSURANCE WAIVER: I am aware that does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requitement. I am the(check one)0 owner ❑owner's agent ' UwnerlAgeat I P17R16IIT W17K.C I Jdo1A44 '1Ct ) /hall«M -77Li_ 3c0ti - pcJ7