BLDE-23-003729 Commonwealth of Official Use Only
Ems, Massachusetts Permit No. BLDE-23-003729
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:1/10/2023
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) 9 GREEN WAY
Owner or Tenant PAUL CONROY Telephone No.
Owner's Address 9 GREEN WAY, SOUTH YARMOUTH, MA 02664
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 furnace/air handler.
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 0 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
Initiating Devices
No.of Ranges No.of Air Cond. 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 ❑ 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 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: 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
L; a------
e.........,........_ Officio/Use Only
- Pennit No_ 23 --37-Z4
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j Occupancy and Fee Checked
WARD OF I-11-th PREVarnai REGULATIONS 1Rev..IA171 °cam blank)
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APFlucKnot4 MR PERMIT TO PERFORM ELECTRICAL WORK
be,....r.i...4 iuomid......1.themassatheseignietriasiciy# m szrada asp
OIL,E A S t PRINT IND 1 K OR TMALL INFOOls0 Date: 1 44 ?3
City or Town of: Y-6,4 r in(... Lt V7 To the ' ' • ., 0 r of Wires:
Bythis application the undersigned:Dives mice-of his orher intention to perform the electrical work described below_
Location(Street&Number) 1 C,--.,ran VO ck./
°Inlet or Tenant- r-Pr:t44 I Con rbf I •TtkpiranoPio. rig I 95?- cliSS
Owsues Address
Is this permit' in con*nufannwith a ha-Herzig permit? Yes ri No Fir (Cheek Appropriate Box)
Purpose of B .ibiiog Utirrty Authorization No.
aining' Serowe- Amps I Vats Overhead[1 Undgrd[1 No.of Meters
New g` ' Aearts / Volts Overhead n kludgrd n Ne..of Meters
Number of Feeders and Ampacity r I
Location and Nature of Proposed Eleclikal Work wi re ci,--it(,n 61 c e____, 6 r hand ler-
(
•
Completion tithe ,i, ' . tot*imaybewslivesayof Wires.
No.of Total
No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Transformers KVA
No..of Luminaire Outlets No.of IllotTubs KVA
Above In- 1-1 rto-st EmergencY lAgitting
No.- of'al!' s Swiramil4 Pool gni& LI timd LI Battery Units
Wu.of Fooreptarkr Outlets 'No.of OB Banners •FIRE ALARMS Nu of-Zones
•No.of Detection awl
No.of Switches 'No.arc.=Burners Inithrthielkifees
Total
_ Pin.annages No.of b-ernid. Taw . 1 of Alerting Devices
f isp
Bea Pnp'Nmbr12ee lKW
N..oWaeDosrs I - of SettAtrsriTptiastDed ice
s
Municipal
No.afiNsttinashets _Space/Area Heating KW '' El CJD 0 Mber
No.ufBryers Beator- i Agmfoosees KW No.of t '-- or Elpibmimt
No.of Water KW No.of No.of
Heaters . ftrts Ballasts No.°Marines or
-- eleemommuleations -
No.llydnonassageBoddnis IN°.of Motors Total RP N uiDentees mr -
, —
OTIIERz- . :_ .
i f,(-L c Afflueb a d tti k i a a a i I a x 1 W.".or Its re"if"the ligss,',-.r a f Wires.
Estimated Vane 6,Vico- -- Wadu bl j...).- - (When kitquitcri by manpal policy.)
Work to Start Mg- invections to be retmested in uttiee with NEC Rule 10,and upon completion.
- IISURAPKX *Pr; . P!-• rildelE Inked.by lic ovnicr,no pczmk fix-thy perfinnance of electrical work may issue unless
the ficonsee lunacies incotof fitialy intramtes imbuing Ninopletal OptBdiES1"UMW or its subs"espivolet. The
undeistvred certifies that mai Fauna is in feitte,lad has eshhited prounrfsaintIo the permit issuirg face.
clipcx ONE INSURANCEA BOND 0 OTHER 0 (Specify.')
IMIO,zetkr the`and premiers*pejo%the tthe infewastertax ass - - islawand imelpkte
FIRM MOM _...."" LECi,NIX:
,
14....--"-S4,6 "-f. c, tiono...1cifi r) sgastare - - ...... ----- LIC.NO....:<5 a a i" E
tvwfreibik poor r it Eirs"lairki "s -4L M 661 41-1-1 Has.Tel-Nu.z.9711-34S C9 VI
Mt) a t.7 I El.-1 •-------3-‘0 ALTeL No4__
Vow)LG.L.c.141,s.57-41,security wort toptitcs Depkrtment aft Safety'''S' Litwysfr Lic.No.
OWNER'S 1114113URA_NCE WAIVER I am tly“oe thatthe Lir:ranee does prat have the liPhility insurance coverage normally
1001Cd by law.By may*Marc lwkras l actetry waive this re". I am the(die ck aim)0 num= 0 owner's agent_
OwaerlAgent i
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geranium Tekpinue No. I PE Irbil'I'FEES 1