BLDE-23-006069 "oi= ,,r Commonwealth of Official Use Only
4.41:tiMassachusetts Permit No. BLDE-23-006069
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:5/4/2023
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 BOWSPRIT PATH
Owner or Tenant FLAGG JAMES F Telephone No.
Owner's Address FLAGG MARGARET E, 66 ROBIN ST,WEST ROXBURY, MA 02132-2148
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 HVAC&add CO detector.
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
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 Total No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 1
Totals: Detection/Alertine 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 Siens 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 ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: David E Coleman
Licensee: David E Coleman Signature LIC.NO.: 17221
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 62 FLEETWOOD PATH, MARSTONS MLS MA 026481048 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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�+� .� Y O 3 2023 cc77 Permit No. 73 o /
partment ell ire Services
1:1-.1fif e 1 Occupancy and Fee Checked
'y �- t , c)ARD Oft IR PREVENTION REGULATIONS [Rev. 1!07] (leave blank)
AFPL ATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRIATT IN INK OR TYPE ALL INFORMATION) Date: 3 / .2 3
City or Town of: ` ',twn e t.,fW To the Ins for 6f Wires:
By this application the undersig,n96 gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) ? 8,,,, Po-t i 19b,V.L,
Owner or Tenant .1, - j /i.o Telephone No.
Owner's Address $ ..y i..e
Is this permit in conjunction with a building permit? Yes ❑ No Check Appropriate Box)
Purpose of Building k„o ,,,,1 ,, Utility Authorization No. _ '
Existing Service Amps / Volts Overhead E Undgrd ` No.of Meters
New Service 1 Amps / Volts Overhead! Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Al. ,,t! �, G p j f �,, y C,e..— 2
Al wc-� e .-h,cs�'- To Ai r..w Co soyi.,,,,,,
. ..-c.. Plu$ e ® 1)...T ---
c p /24.e Completion of the following table may be waived by the Inspector of Wires.
Total
No.of Recess Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of KVA
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Pool Above ❑ In- ❑ No.of Emergency Lighting
No.of Luminaires Swimming rn gd, 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. Tons No.of Alerting Devices
No.of Waste Heat Pump Number Tons KW No.of Self-Contained
DisposersTotals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW "cal❑ Municipal ❑ Other,
Connection i
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water', KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Eckuiva)ent
No.Hydromassage Bathtubs No.of Motors Total HPTelecommunications Wiring,:
No.of Devices or Equivalen ,
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 4 v o . — (When required by municipal policy.)
Work to Start:',. / 3 /?3 Inspections 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 cove is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE a BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that thormation on this application is true and complete.
FIRM NAME: Lo/4 0 , je�.d". t, ..I t, LIC.NO.: .4.---:,9'!do 7
Licensee: �v4�.'a1 Signature K.�.i G. LIC.NO.: / /7 2 2 )
(If applicable,enter"exempt"in the tic nse nu ber line.) Bus.TeL No:v ei 3 4 c/' —
Address: 6.2. ,.170-4j:v�4 i'`/ O IQ / I Alt.Tel.No.: 8ti,.t"6
*Per M.G.L.cl 147,s.57-61,security work requires Depaitnient of Public Safety"S"License: Lic.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)❑owner ❑ owner's agent.
Owner/Agent
. Signature 1 Telephone No. PERMIT FEE: $