HomeMy WebLinkAboutBLDE-21-001039 Commonwealth of Official Use Only
.--7 Permit No. BLDE-21-001039
i
Massachusetts
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
LRev.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:8/31/2020
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 electrical work described below.
Location(Street&Number) 33 PINE GROVE RD
Owner or Tenant FORD EDWARD R Telephone No.
Owner's Address FORD MARGARET G, 183 BRIDLE CROSS ROAD, FITCHBURG, MA 01420
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Approp ox) //
Purpose of Building Utility Authorization No. ` ( 0
Existing Service Amps Volts Overhead 0 Undgrd 0
►� e
New Service Amps Volts Overhead 0 Undgrd 0 I . , s
Number of Feeders and Ampacity , 0 '
Location and Nature of Proposed Electrical Work: Wiring for split NC system. 80 /�
Completion of the following table may be waive a fe; 1Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of
Transformers4
No.of Luminaire Outlets No.of Hot Tubs Generators
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. Ig iii.
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. 1 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 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 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
02,4 1/«f ft
- APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All wok to bereeiomedisaccordance milk Ike illimachenets Electrical code arte1200 _(0_,039(PLEI T PRINT IN INK OR FALL IN ORWATICN DUO: S y 7 1c 0
get
City or Tam at fG rm C u-4'1'1 To the Inspector((Wires:
By this application the undersigned gives notice ebb or her Mention to Pinar the decried work described below
iweatiin(Street&Non siu) .33 P?h e Greve,. Rd
Owner orTem* MCtr-, c r'ck Ford TdepheneNi. 115.61 a -'leo i,
Owneese Addams
_ Is!illi penult is cssdonedso with a 1taYdig peewit'! Yes 0 N. 0 (Ciee*ApprsprisieBo*
P.rpan a fBabliog Utility Andmrissfiaa Na
Rsistfig service Amps. / Voles es Overhead❑. Unigrd❑ N..*Mien ____
Nitrate's Assns / Vella Overhead❑ Unaged❑ No.ofMclRs
Number efsaeiets and Aarpseity .
Laced..and Adam sfProposedgiectridWork Wire du . rzt, s[a1N—d ud (e 3
No.ofRe essea l<.e.daakes N..efCeiL-Sone.( addle)Ms Train oro era KVA
Mo.oflam■aiseOedeb No.efHatTis Cenral= KVA
N..— lAmsi eines Swilmeilla raden angergascy Lagoon
�a. ❑ ,Tharp
Na efBeoepbaele OEMs No.of Oti 1horners MR ALARMS INe.of Zones
No.of Switches No.ofcgs Baruch: iN'`oilletectims nod
badatim Darken
Tuba
No.all sages Na.efeirCelli Tens ..Na.afAk davgDe.ices
Na efWasleRimersHat Pomp SelFdmqateed
� s V 'KW ►ee
Ne.edDhim akers Space/Ana Heeling KW Lot❑ ❑Ober
NIL etDrles Main Appliances xvvPia 1 • orBaubrale t
•f Water Healers KWrem Data
la 1/Pk elE er
, g
No.Hydrea e s Na of Metors Tsai WP ,! Pia e[Devi 1p or
OTHER:
Aitech additional detail rdesintit or as regmbedby the Inspeetor efWiree
Estimated Value ofE earical Wada (What reepieed by municipal policy.)
Waldo Stat Inspections be isted in acrdwM*with MEC Rule 10,and upon aompletioo.
INSURANOI COVERAGE: Unless waived by the owned no permit for the performance ofdefia1 wet toy issue unless
the licensee provides proofaf liability imam e k adioeOompleled ope retina"coverage or its substantial egedvalet: The
u ndersiBued certifies Oat such coverage is in kw%melbas addbited pioofofsame to the permit issuing office.
CHECK ONE: D1S[JRANCE 11--IIID 0 �0 pr its aplaliereliar s daemmeielraapaieds
I nailer d uepwws eel pewnisiies rfp R
FIRM '• z LW.NOS:
Licence~ •t /WA_— - 0 i sigoaaaae ` IAG moa.:$i9 i E
jb'apprreabte 'b. license n tuber lobe,) • . Bao.TeL N.YI'i-3i,,3-& l,`
Adduces: c r tic h eQa il.1. Qn�S Alt:Tel.x..:
*I[GI..G147,a57-61,seasdb►wrst ufPalkSas1,y"�'Lieense: Lic.No.
OWNER'S INSURANCE WAIVER: I am to Licensee does not have the lhbi ky'nascence coverage:normally
required by law. By mer signature below,I hereby waive lids rapdrement I am the(check out)❑owner ❑owates agent
Ovvueddgent
Slostone Teieplooe No. IPER [l7F $
Robert Bowdoin
502 Pitchers Wy
Hyannis MA,02601
774.318.0767
bowdoinelectric@gmail.com