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HomeMy WebLinkAboutBLDE-23-001539 Commonwealth of Official Use Only . Massachusetts Permit No. BLDE-23-001539 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:9/23/2022 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) 14 RICHARD RD Owner or Tenant BRIAN GYTHRIE Telephone No. Owner's Address 14 RICHARD RD,YARMOUTH PORT, MA 02675 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: Wire 2 central system replacements. 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 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 2 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 Z tmmoaweug O,aM tt4 Official' uxOnly • Pcermit No. (-L3 s 3 q I Occupancy and Fee Checked • a fRev-I/07] (leave blank) r4s �+: BOARD OF FIRE PREVENTION REGULATIONS APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All%wok to be perfoinied w accordance with theMassachusetts Electrical Code 527 CMR 12_00 (PLEI4SEPRTh1T IN INK OR TYPE4LLINFORAIATIO11O Date: 1 =2 c �,— City or Town of: yo(in OLith To the ctor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 14 / i ch c rC) c) Owner or Tenant 3 n Li 0 (=-t1 C l C., Telephone ma/6 A 10-053' Owner's Address Is this permit in conjunction with a building permit? Yes I , No (Check Appropriate Boy) Purpose of Building Utility Authorization No_ Existing Service Amps / Volts Overhead n Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd n No.of Meters Number of Feeders and Ampacity the1 Locution and Nature of Proposed Electrical Woric W 1 r e R C e n fra L Sy5-h9'h s. �' merit- Completion - Completion of folio vinq Ale may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Cell-Susp.(Paddle)Fans Transformers KVA No.of Lnminaire Outlets 'No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- Q No.of Em ceacy Lighting Eruct. !sand. .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 I Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No of Waste Disposers Totals: Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating kW L l❑ �cipnt ❑ OtherCMOIIIIettlOII No.of Dryers Heating Appliances IOW SecuriNo of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or alert No. Bathtubs No.of Motors Total HP Telecommrrrricatians : Hydromassage No.of Devices or Equivalent OTHER: !Torah additional detail if desired or as required by the Inspector of Wires. Estimated Value Work: 30 LC.©O (When required by munir►pal policy.) Work to Stall_ G )C a Inspections in be requested in accordance with MEC Rule 10,and upon completion. INSURANCE GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance inclnd;ng"wmpleted operation"coverage or its substimtial 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 ❑ OTHER ❑ (Specify:) I certcjy,under the pains and penalties of perjary,that the information on ' application is true and complete_ FIRM NAME: LIG NO.: Licensee--Rt b c r* E eD(.0 de i r) Signature LIG NO.:61 g 8 I- E r7Uapplieabl& exc pi"in f /WSW hue Bus.Tel.No.:Ti 4-3 6S-07(37 Address: i <\J elt r i t5 ri 4-1tile\ i in( 4.—1 3 t t'- Art_TeL No.: *Per MGI,.C.147,s.5741,security work requires I) cut vfPublic 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 Telephone No. 1 PERMIT FEE: