HomeMy WebLinkAboutBLDE-22-004904 . �
Commonwealth of Official Use Only
Massachusettsivakti
Permit No. BLDE-22-004904
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:3/7/2022
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) 17 BELLE OF THE WEST RD
Owner or Tenant Donald Coakley
Owner's Address 17 BELLE OF THE WEST RD,YARMOUTH PORT, MA 02675 Telephone No.
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check reyriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 0 No. t t New Service Amps Volts Overhead 0 Undgrd 0 f ,,,"
Number of Feeders and Ampacity
iN 4,4
Location and Nature of Proposed Electrical Work: Wiring for 3 A/C's, furnace,water heater and replace pay/
80
Completion of the following table y e w b 'i .:-ctor of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of
ie,l
Transformers A
No.of Luminaire Outlets No.of Hot Tubs 22
Generators KVA
No.of Luminaires Swimming Pool Abovernd. ❑ In- ElNo.of Emergency Lighting
g grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones
No.of Switches No.of Gas Burners 1 No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. 3 Total
Ton No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number I Tons KW No.of Self-Contained
Totals: Detection/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal
Connection 0 Other:
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water 1 KW No.of No.of Devices or Equivalent
No.of Ballasts Data Wiring:
Heaters
Siens No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
OTHER: No.of Devices or Equivalent
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(If applicable,enter"exempt"in the license number line.) Tel. NO.: 51981
Address:502 PITCHERS WAY, HYANNIS MA 026012582 Bus.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.:
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 ❑ owner's agent.
Owner/Agent
Signature Telephone No.
I PERMIT FEE:$100.00 I
Occupancy aad Fee Checiaoi
i1/4,_ }
SIN FNE PREVENTION � j
APPLITKAI FOR PERMIT TO PERFORM ELECTCAI.WORK
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Number of Feeders and Aospaelly
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