HomeMy WebLinkAboutBLDE-22-004645(`
con Commonwealth of Official Use Only
REV,f.tIt Massachusetts Permit No. BLDE-22-004645
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:2/22/2022
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. /o
Location(Street&Number) 23 BANISTER LN 7a l " ,7(rr
C$" 0535
Owner or Tenant Colleen Courtney Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check 40 1 . Box)
Purpose of Building Utility Authorization No. 7
Existing Service Amps Volts Overhead 0 Undgrd 0
o
New Service Amps Volts Overhead 0 Undgrd 0 te
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Replacement HVAC
Completion of the following table y iv d-.�.•. ••ctor of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of tal
Transformers Oj
VA
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 1 No.of Detection and
Initiatine Devices
No.of Ranges No.of Air Cond. 1 Ton l No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Containedat
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 n
No.of Water KW No.of No.of Ballasts Data Wiring: -4
Heaters Siens No.of Devices or Eauivalent
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 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
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OccuPncYawl Fee gawked
'T 11--:-* BOARD CW RRE PREVENTION REGMATIQNS_ row-liOn pine atulk)
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APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
An'9 Ikta beisofeessectin accoulauce eft die Massockentis EkcificalCode f, 7 a at
(PF FAST PRINT BO KOP TTALLI INFORM-MOM Date: / --
cityorTownof . TQ lerh0[i h To the , ,,,..,rt7 of Wires:
By this apiAcatire gee undasigaed gives aattce afire or-fir' peed thenbudrical work wed Way.
Location(Wed& ) Bar, ,5 -er- La te
etia
CAI ee.� 'Qvr +i) T - '79d" ,cog-6 5
tsrTtat v
Owner's I -
Is this puma he castiUncreee with a bontruig permiC Yes D Nei El (Check APp Box)
.:... -
Exisrmag
Service Alurg I Veils Overhead ElundadEl Ne.efMeters
New Service .ems r Yam Overhead El thiatad '- roof
Number of Feeders and Am y sl 1
N err wee 1-A1 ►re rieu)-€4 mac( f RtiC
c
Omplarsion alike followeinv a imorhe waived ap ike hispeciar of Wires
ef�eo�ed -Nu of -s_-t FansTrrao. es KVA
No of Lie Outlets 'No.of Ha Tubs tears KVA
1-1 No-ot Emergency LAighligg
No.el'
- Peel=ye 13 Ungs
'Ns.ofitemitade Oudets No.refODBurners MIRK ALARM iNo.ofZones
°Melchor No.afGas.Burners
laef N .of Its" '- 01
- , ,I tTNo.of S
Na o€Wam� Totals: -T .Deteelinnhilet."2 Domes
.Nu.of - Area Heating KW 'Leesi'[l I a II.Other '
efts KwNo-°Mariam or Ea:neatest
Security Systme.u*
Nit.ofWater. 1 .of No.of DataVirarkw
aden
lSens No.of Devices or Etiviratett
, No.Iirdremessege Biddies No.ofMe tus Total Hp fi i
f I or s r ate °from
Estimated VeliteofEreceitallarack (W by pow)
Wank to Stint_ __ _ _. - in be letPlatedin accookoicevalh MEC R le1Qandaponco ple n
Il RAN RAC&Was waived by us owar,i)penni fir the pains=urclatrical work Duty issue m
ans
the licensee wars Pructictiliabilityilkaltellee` opeigioe cOverage Ork Sedarthal
***it IV
undersigned thatsest covence s it farce,and has reththited proofersentero the pa issuing office.
03ECX tom: DEURAMM V BOND El OMER El (Specify:)
Itt 'kept* ti &d Ms amireoidei Is legeand
F _ - a'iQ,
- - 'E �-- _ LIC- I`ll
1) er �-';►#. do trl -- _ N .:5 E
*PerM..G.L.c. 47,S.�, y ca Ilene) -Kid - .. _ .. .ofPnbre Safety"S'Limns= iic.No:
OWNEWS rawaAtFtLZ WAIVER: I ant aware that timLi once does not Jae theroinTity ire a mentally
rwbcd by kw. By ay aged=behre,I hors wit is verbenas& I math*(ems one)Q owner []owner's agent-
OWneriAVIli
Telephone lilo. 1 PERMIT :$