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Home My WebLink AboutBlde-22-003513 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-003513 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.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:12/23/2021 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) 15 SIERRA WAY Owner or Tenant COSTA DONALD A Telephone No. Owner's Address 15 SIERRA WAY,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 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: Replace 100A panel, add outlet/wire for portable 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 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 Initiative Devices No.of Ranges No.of Air Cond. Ton l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine 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 Siens No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: RAY W BOMBARDIER Licensee: Ray W Bombardier Signature LIC.NO.: 33621 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 2443, MASHPEE MA 026498443 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 �/ /.44et4:61 1 A7/.t 4v 1 RECEIVED ;s ° DEC 2 2 202h, .a/th 4 m sate Official Use Only Q n ,rr_ c'� Permit No. tTzZ-- 3...0 tJ : � C L D I N G DEPART hi 4.. ire-Cervices — Occupancy and Fee Checked ' y BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/07) (leave blank) 1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 51 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: .1 a...1.) t CAI City or Town of: \I i 411,011 J 11,4 To the Inspector oWires: L= By this application the undersigned gives notice of his or her intention to perform the electrical work described below. (V i Location(Street&Number) (5 5-I oR14- Ki 14-y Owner or Tenant O Ot1 ) C04,T'A Telephone No. SQS 3614 At 7 t(D Owner's Address 4544,0e i Is this permit in conjunction with a building permit? Yes ❑ No IR (Check Appropriate Box) Purpose of Building Utility Authorization No. 0 Existing Service 1100 Amps 0-0 /210 Volts Overhead[A Undgrd E No.of Meters New Service 10° Amps W /a-3'1O Volts Overhead 0 Undgrd 0 No.of Meters 3 Number of Feeders and Ampaclty 3 I ou9 A- 1... Location and Nature of Proposed Electrical Work: 12..1Z p`vq_Ll,-o tp o tq 1.1..Ct a t t; ()ANC C I L t rt4 0-ew 9v4cv-Ll 4- ()2 ice(2-5 , ►o ri -cl,co Lisle Da-- G,II^' -A--r0(2— (z�tq c.lc v P. Completion of thefollowingtable m9,be waived by the/ns ector of Wires. No.of Total No.of Recessed Luminaires No.of Ca.-Snap.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmin Pool Above ❑ In- ❑ No.of Emergency Lighting g grad. 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. Totals 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 0 Monnectiounicipaln 0 Other C No.of Dryers Heating Appliances KW Security Systems:1 No.of Devices or Equivalent No.of Water K�,t, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications W No.of Devices or Equivalent nt OTHER: V o Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lectfical Work: 115 04° ' (When required by municipal policy.) Work to Start: I?-lei ,).) 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 0 BOND 0 OTHER 0 (Specify:) I certify,under f and penalties o,[pe ply,that Misinformation on this application is true and complete. FIRM NAME: '� INA 00`(,� ,I 0 ry`(j (('\\p[E"3'L LIC.NO.: 33(a 1-E_ Licensee: OA Y1'VN Q<H(3014 V �D/$tSignature�11Es..-�/G.. IC.NO.: 3 3 (0)-1 - (/fapplicable,enter"exempt"in the license number line.) �� Bus.Tel.No.. Address: 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 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. Owner/Agent Signature Telephone No. `PERMIT FEE:$