HomeMy WebLinkAboutBLDE-21-002766 BLD R Commonwealth of4\ Official Use Only
L Massachusetts Permit No. BLDE-21-002766
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:11/16/2020
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to pertorm the electncal work described below.
Location(Street&Number) 248 CAMP ST
Owner or Tenant FOXWOODS CONDOS Telephone No.
Owner's Address CONDO MAIN,248 CAMP ST,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 exterior fixtures, receptacle, &reattach meter socke
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
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 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: DAVID W SPRINGER
Licensee: David W Springer Signature LIC.NO.: 21170
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:70 Bishops Ter, Hyannis MA 026012106 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: $200.00
-\ Commonwean oI Viaeeacjuwlfs Official Use Only /,,
T. t ryc�, gC7 Permit No. v ' 2.7`�
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1L _,:rt. t4 3.partnwni o�,}ins�ervae s
!_ Ii a==A Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
'21 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
vI (PLEASE PRINT IN INK OR TYPE ALL I�.0 INFO TION) Date: ` 1 l I 2-04 City or Town of: 1 Yrid t)L To the Inspector of Wires:
U 1 By this application the undersigned gives notice of his or her intentio to_perform the electrical work described below.
CJI Location(Street&Number) V C S . . - 0d. (Si l�ti, •
R
,__t �` �1 -- -t—. —r-°.
r !1 Owner or Tenant C VX WOO f� S Cps,)o Sk t Telephone No.
N Owner's Address
Is this permit in conjunction with a building permit? Yes �No 0 (Check Appropriate Box)
Purpose of Building U WC, �z�5 ) Utility Authorization No.
.5) Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters
C
New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters
c,.- Number of Feeders and Ampacity ^,LL
Location and Nature of P posed Electrical Work: toyl)�z ck;t C\k- ,t ((``T S 1
()A ricd( bink �4*5 , a *& i( W 9 S .t i'`.at rte{- 1 c 5
P Co,Apletton of the followingtable may be waived by the Invertor of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tof Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires swimmingPool Above 0 In- ❑ No.of Emergency Lighting
Qrod. gird. 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 Mr Cond. Tons 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❑ 1Glunnectinicipalon ❑ Other
Co
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of WaterKW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP
TelecommunicationsofDevicsor quiv Wiring:
No.of Devices EQuivalent
OTHER:
/ nn rr������ Attach additional detail ifdesired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 4tV�1,w (When required by municipal policy.)
Work to Start: I O j /ZD 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 cove is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE [BOND 0 OTHER 0 (Specify:)
I certify,under the pains and penalties o perjury,that the information on this application is true and complete.
FIRM NAME: - ''.`C i tl tC Ek k ci-c 1-c_ -, i LIC.NO.: Z 11-]G fi
Licensee: 1),.ZV F U 5 t.::-.%.11‘'A' �C Signature 1 —i ' LIC.NO.: 13 L/f applicable,enter"er pt id the lici number li ) 1 Bus.Tel.No.:50$ 3f.0 Ogig+ ��� _1 1
Address: .7C) Cl, Sc o O 5 �`.elho -3- Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requirestplepartment 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:$