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Home My WebLink AboutBLDE-23-001314 0, Commonwealth of Official Use Only ' E Massachusetts Permit No. BLDE-23-001314 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:9/12/2022 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) 14 CAPT CROCKER RD Owner or Tenant JACOB MARTIN Telephone No. Owner's Address 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: Replacement distribution panel 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- ElNo.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 Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices ,Ton 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: C9nnection 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 Sieps 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 perjug,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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 c a. o/I3( v L RECEIVED 0 412 � A SEP 2�22 A� Q1 �,µ.-r Y ,, otnttronweutttlr o` eac aea�e ' �y `"'Pi Official Use Only ae �� - �;`='. :UILDING DEPA ENT n • V 1I- By — of o`�i+,e Serviced Permit No. a2�j-- 1 3(144 OJ BOARD OF FIRE • PREVENTION REGULATIONS Occupancy and Fee Checked ( Rev.1/07I leave blank I APPLICATON FOR MI to be PERMIT TO PERFORM ELECTRICAL WORK performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) ate: M city or Town of: — YARMOUTH To the Z ) By this application the undersigned gives notice of his or her intention to perform the electrical ork e Q.) Location(Street&Number) 4--J described below. Owner or Tenant Ai C O C .4' E O , 4" Telephone No. f�/3' 7 t. , Owner's Address ' Is this permit in conjunction wi• a building permit? Yes Purpose of Building ❑ No ❑ (Check Appropriate Box) • Existing Service Utility Authorization No. Amps Volts Overheadrj New rvice Amps / Undgrd❑ No.of Meters l Vo . n Number of Feeders and Ampacity Undgrdw Overhead Ell El No.of Meters — 3 C Location and Nature of Proposed Electrical Work: _ S` u 14/ N 2 ��-5� t� 0/ No.of Recessed Luminaires Com./etion o the of/owin,table m. W gd"�1Z ��_ No.of Cell.-Sna be waived b the/ns, ctor o {i'b es. r,, No.of Luminaire Outlets P (Paddle)Fans 'o.o KVA No.of Hot Tubs Transformers No.of Luminaires Generators KVA RF Swimming Pool rntl e ❑ ,and ❑ 'o.° mergency g -n No.of Receptacle Outlets Bette Units g :� No.of Oil Burners IZZIMMII" No.of Switches No.of Zones �; No.of Gas Burners `o.o t etec on an • No.of Ranges Initiatin, Devices No.of Air Cond. ota • No.of Waste Disposers 'eat am Tons No.of Alerting Devices P `um er oas _� `o.o e Totals: ......_.-..--._...... ......_..._...._. No.of Dishwashers oat: n Detection/Alert • Devices a Space/Area Heating KW 'an No.of Dryers Heating Appliances Local Connection 0 Other `o.o "a er KW ecu ty yevices Heaters KW `o.o .o.o No.of Devices or •ui•'aleat No.Hydromassage asaage Bathtubs S ' •s Ballasts Data Wiring: No.of Motors No.of Devices or •uivalent OTHER: Total HP a ecommun a•ons " No.of Devices or E•trivalent Estimated Value of El trical Work: 00 Attach hen additrequired detail desired,or required bythe Inspector to Start: r� (When required by municipal policy.) 9 p of Wires. WorkSURANCE CO Inspections to be requested in accordance with MEC Rule 10,and upon completion. INRAGE: Unless waived by the owner,no permit for the performance of electrical work mayissue the licensee provides proof of liability insurance including"completed operation"coverage or its undersigned certifies that such coverage is in force,and has exhibited proof of same tol unless CHECK ONE: INSURANCE the permit issuing office. CHECK The I certl•j,�,under the 0 BOND ❑ OTHER (� (Specify:) FIRM Npenahies a-LJ V) t(he 1 tjon on this application is true and comp/ate. Licensee: penal_ C (Ifapplicable,enter' Li ��t91 Signature LIC.NO.:c�Address: exempt"in the license number line.) tom/ rar LIC.NO.s j-5(u:,,t .--e- #Per M.G.L.c. 147,S.57-61,security work requires De Bus.Tel.No.• OWNER'S INSURANCE WAIVER; I Department of Public Safe Alt.Tel.Na: - �� required Owner/Agentby law. Byam aware that the Licensee does not havehe liability insurance coverage normally required my signature below,I hereby waive this requirement. I am the(check one Lic.No. Signatur q Y Telephone No. owner owner's a:ent. PERMIT FEES a