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HomeMy WebLinkAboutBLDE-22-005333 - Commonwealth of ir� Official Use Only Massachusetts Permit No. BLDE-22-005333 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:3/24/2022 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) 88 PINE CONE DR Owner or Tenant BARCROFT JON W TR Telephone No. Owner's Address THE BARCROFT FAMILY TRUST, 88 PINE CONE DR,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: Upgrade exterior service equipment. 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 rnd. 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. To 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 ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs 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: 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 if; 61te ' /7 Rom' ile a— i Ns P.cc->:-"l 0 it t t ex.)---5 ( t-e___ A _ Commonwealth o/Maddachadeitd Official Use Only 1 x Vw •' Apartment Permit No. �Z 3 c i �l oUepartmerzl o��ire Serviced v" Occupancy and Fee Checked •• n `� ° . , BOARD OF FIRE PREVENTION REGULATIONS [Rev."v ''„ ,,' j (leave blank) v APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK `, J All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORM c� cATION) Date: r'3 p, VCity or Town of: " - To the Inspector of Wires: By this application the undersigned;gi es notice of his or her intention to perform the electrical work described below. Location(Street&Number) ?c,I) `€ CV I.! £f) Map Parcel# 0-- Owner or Tenant A t jLA FT" Telephone Nor 7?/fly Owner's Address 51 Ss P(1 Q--GO( -- On— V1/4-)y44-2, MO 03-(o g II @,....) Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Au horization No. Existing Service ` Amps yjk/c9SIDVolts Overhead Undgrd❑ No.of Meters 1 New Service ` Amps PO o t7 Volts Overhead tg-------Undgrd❑ No.of Meters I c t Number of Feeders and Ampacity '3 t�'p �/J Location and Nature of Proposed Electrical Work: PCBsiN t(yI ems_ W t T ,ma_ .'---T i (1r1,.4-i 4J r M-2. Li 1131e7 CA-6 t tr (.L I P5 / Kre-to 9 ez ..)0 t Completion of the following tale may be waived by a Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA dNo.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting r grad. ❑ grnd. 0 Battery Units `Y� 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 Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number -'Pons KW No.of Self-Contained = a, Totals: Detection/Alerting Devices _ No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection 3 No.of Dryers Heating Appliances KW gecurity Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Sins Ballasts (�'\► l; 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 lectrical Work: ( ©t9 O (When required by municipal policy.) Work to Start:Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C RAGE: 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 [t BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complex FIRM NAME:RAi$04,S .)t'i i ( e.;VAC:i LIC.NO.:D-` 3?j( -` Licensee: Signature 11,,01 02)-„ 4,- LIC.NO.: (if applicable Etter"exempt"in the license number line.) Bus.Tel.No.No44 CM C9IY1 Address: yn ie) SLii1 iCV W M A4L-jeci ion,4. _fei- Jfi Alt.Tel.No.: 404(TAW.. *Per M.G.L.c. 147,s.57-61,security work requires Department of Public afety"S"License: Lie.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ 6 *IMPORTANT:A separate permit is required for the installation of smoke detectors.Fire Ala m inspections are performed by the FD having jurisdiction:. .i.,..xr.r...n„INNA..,rr` \ Ir. ), it i,VLAI I.-G►eill