HomeMy WebLinkAboutBLDE-21-001933 C-11/111414 To Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-21-001933
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:10/14/2020
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) 8 SPRUCE ST
Owner or Tenant PAVEL NELYUBIN Telephone No.
Owner's Address 8 SPRUCE ST,SOUTH YARMOUTH, MA 02664-5632 //7
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ap op S, s 2
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 0 o e
New Service Amps Volts Overhead 0 Undgrd 0 No.Number of Feeders and Ampacity n...,
VVVLocation and Nature of Proposed Electrical Work: Receptacle for water heater. O O
Completion O.the following table maybe waived b .r of Wires.
K+
is!)
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of
Transformers
No.of Luminaire Outlets No.of Hot Tubs Generators KV
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiatine 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/Alertine 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 Siens 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 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 Telephone No. PERMIT FEE: $50.00
vt / 322 1Z1 l
A emeadit st/M ,emi& ,-til 1lsee�9 33
�� Permit No. C—(
I ___
BOARD OF FIRE PRE11�7iil�llq NEGUIJi llms fieweliben
APPLICATION FOR Pte'TO PERFORM IBUECTRICIIL WORK
iAll work to be performed in acoadaaoe with the Massachusetts Electrical Code 577 CM MD
(PLEASE PRINT IN INK OR ALL INFORM TION) IDailc 1 ice)a
City or Town of: 6(`fliOu'�i lbtbe '•f :
By this agpi'iaalion the antes en" ed ghats addtim 01 s or heridsdi ndinpt fammil eibee oalwtsi amallsdl>i _
mets nlet het&lassie � ` r t1 cx .. -.
_ ow.eraa•llhnest AGN e_I ►Vel u b do (a l - 4 o- 4B 7
; Owner's Address
Is this permit In coeju etlsa with a buEdthqg permit? Yes 0 No 0 (Check A e
Pum of Building ilAta.
Existing Service Amps I Vats Oaesiaall❑ >ot.}a® Iliie.athMYtias
1Asps I Veils Overhead L 0[D Ilimailillituen
Number of Feeders and Ampacity
Location said Nature of Proposed Electrical Werk: i r - e,a n n ca i. (oa he u-ter-
V CbaeibNsw edWbvs
cv; No.of Recessed Luminaires NIL of 'wap. 1)cv Illsm ildsds Milk
c., No.of Luminaire Outlets Nu 011 oris
No.of LsaadaaIres 8iwhaadi!llti Ahem® [El)Jithurgithmiammasythilithisu
o fltiMs
Ns.of Recptacls Outlate No.of OE Barters FIRE ALARMS J lush awes
No. enththethas IMI
of Switches No.of Gas Burners
leilblinn Dodos
s No.of Air Coad. Trnd Noy.s1Al er■e Bain
Tons
No.of Waste Disposers Matron*I Number Tins I KW D Wale: i■es
1
bbw
Nor of Dashers Space/Area Heating KW Load❑ 1]O�sr
No.of Oryen Hosting Appliance KW %murky
No.of= rlinsii1ent
No.of Water KW No. No.of Data Wiring:
Heaton Sims Bad � No.of Dovtoes or
;�r
HydromassageNo. Bathtubs No.of Maters Toad HP elmonunindeathms
No.of Devices or
OTHER:
Anode adddtioad detail Vdeslred oras requbod by die Ipa for of Mires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to StartInspections 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
1 egaiy iissue The
the licensee provides proof of liability insurance including"complexi operation"coverage
or its 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 (Specif) tddpal
I curt ander the pains and penalties$1�M7,that the ifennatiee et this 1ppl cation A drum aLIC.and aempletG
FIRM L�.pp:�c1� 1£
I, WC.i C.�l rl � Bus.LIC.1a:S-1- 4d i£ 7
Address:
' ra+ap¢el 1
K,10� 1..frP1 Alt.reL'lQw:_
*Per M(i.L c. 147,s.57.61,aecuuity work -, r -, . i,<-,, of Public Safety"S"Limos= " l ic.No.
OWNER'S INSURANCE WAIVER: I sin aware that the Licensee does not have the lift normally
required by law. By my signature below,I hereby waive this requirement lam the(ehrick me❑oar ®owner's agent.I
Owner/AgentTelephone No. j ;