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Home My WebLink AboutBLDE-23-001169 Commonwealth of Official Use Only Permit No. BLDE-23-001169 '; Massachusetts '*-.0 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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:9/1/2022 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 el ctrical work described below. 1 Location(Street&Number) 897 ROUTE 28 .A-jV U 7- - t', io c Q v Owner or Tenant TUE'tA!7NDRYCENT€R..O �%a OU INC TR Telephone No. Owner's Address C/ 1'-GTR-0.E CAPF R;$97 31#E-28-,- _ T.IJ.,,_MA-02W Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. / 'i_,- 7 'Li, Existing Service Amps Volts Overhead 0 Undgrd 0 No.of eters (vie/(;'6 New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters ' " IS;- _W WY- Number of Feeders and Ampacity `i; I`t(- -1 Location and Nature of Proposed Electrical Work: Disconnect,from panel&remove, all wiring except office and bathrooms. Re-activate service. 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- ElNo.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 ands w °' Initiating Devices No.of Ranges No.of Air Cond. To No.of Alerting Devices No.of Waste Disposers Heat Pump I Number l I Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection ❑ Other: 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: Ray W Bombardier Licensee: Ray W Bombardier Signature LIC.NO.: 33621 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 2443, MASHPEE MA 026498443 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: $100.00 �t ( li 6 &( 9�7112 t. .f• : � � ,�, �...� ot5-J itseci oUi' Aeitcii . --.--:---TiRFcE.Iv__E 1 ,,,„,r SEP 012022 1 i' 4 ., DING DEPART nwaatth o/cc/��//�aachuestfe Ofl Usel/y .."_., " '0,.. v:_ K..f wrt`msnE o� tirs�irvasQ Permit fNOTi3t7CnC� to .f Y BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked '� Rev. 1/07] leave blank �— 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: : ' City or Town of: YARMOUTH To the Inspector ofWires: By this application the undersigned giv notice of his or her intention to perform the electrical work described below. ' Location(Street&Number) Owner or Tenant , 0/ — ' -- 4 , -,t . .../ ✓ .. _ T`I phon TNo. ,/ /J Owner's Address _ /lo G sti h f Is this permit in conjunction with a buildingc.- r / -,� permit? Yes 0 No 0 (Check Appropriate ox) Purpose of Building Utility Authorization No. Existing Service Amps / ./ G Volts Overhead '_ A N w ry Undgrd❑ No.of Meters g' —ice �"' Amps / Volts Overhead Undgrd 13 Number of Feeders and Ampacity r .CO 3 ❑ No.of Meters Location and Nature of Proposed Electrical Work: \� 'p 2v�. 2;' wt.c � � NA - c.„ t- f= C c t ^ C Lei t i. on the ollowin, fable m be waived b the/n .ector o Wires. ni No.of Recessed Luminaires No.of Ceil.-Susp.(Pa, ; e)Fans T°'o ota No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA --t No.of Luminaires • Swimming Pool Ve n- ' U. ne mergency g n �t No.of R � °d' ❑ d. ❑ Bane Units g eceptacle Outlets No.of Oil Burners ;?� FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners `o.o i etec on an 11,i No.of Ranges Initiatin. Devices No.o Mr Cond. ota No.of Waste Disposers 'eat 'ump 'utr�6er o a°ps No.of Alerting Devices Totals: Mil ° o e onto ne No.of Dishwashers Detetection/Alertin Devices Space/Area Heating KW Local 0 'un c p No.of Dryers Heating Appliances KWecu ty Cystems� n ❑ �er t `o.o "a er .o o No.of Devices or E,uivalen Heaters W K o.o Data Wirin S ns Ballasts No.of Devices or E,uivalent No.Hydromassage Bathtubs No.of Motors Total HP e ecommun ca,ons " ,g• OTHER: No.of Devices or E,uivalent Attach additional detail ifdesired,or as required by the Inspector of Wires, Estimated Value of$Ie-trieaD Work: to Start: (` (When required by municipal policy.) p P° � Y) WorkSURANCE C L Inspections to be requested in accordance with MEC Rule 10,and upon completion. GE: 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 ❑ OTHER I certify,under the airs and 0 (Specify:) FIRM NAME. penalties of perjury,that the information on this application is true and complete. 2. Licensee:i�..-` er.1;•�L� Signature /` / LIC.NO.: __. - (f applicable ter"ezem t 5 ��_ LIC.NO.: 1 Address: �P in the license ber line.) �� ' C`' 1-;` '_ Uc ivl h r�rr� not.4 C�'r7 Bus.Tei.No.:*Per M.G.L c 147 s 57-61,security work requires Department of Pubhc Safety"S"License: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally Lic.No. required by law. By my signature below,I hereby waive this requirement I am the(check one Owner/Agent owner y Signature -•_ � owner's a:ent. Telephone No, PERMIT FEE:$ 00 �'