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HomeMy WebLinkAboutBLDE-23-000060 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-000060 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:7/5/2022 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) 91 WILLOW ST Owner or Tenant NINETY ONE WILLOW REAL ESTATE LLC Telephone No. Owner's Address CIO MILL LANE MANAGEMENT INC, 231 WILLOW ST,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes ❑ 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Outlet for sewer ejector. (IFAW) 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 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ 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: $80.00 o) 1[� /M� off Use Only � !, •— --�'I ct Rws %c7nl p 3.f#� Permit No. l J��IC( 1�-, ' 13ear tend`�minx JsrurceS J - Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] lzy bin+k) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All Nvork to be performed in accordance with the Massacres Electrical Coda C), CMR 12.00 (PLEASE PRATININKORIIFEALLLINFO TTQ1V) Date: �G 7 '-- City or Town o Yi ((Y\c L V1 To the Inspector f Wires: By this applicatctn the taidaaigned gives notitie otitis or lief' - to perform the electrical work described below. Location(Street&Number) C 1 low. Cc- Jae Owner or Tenant J_r) y\(1-4-1 e)n c R4‘,4_ o e- Pr),M4/ elephone ,No.SCU ;' k) -5L 5 LJ Owner's Address - (, •'.3 f 3 MC.f c ) Is this permit in conjunction with a building permit? Yes Li No ❑- (Check Appropriate Box) Purpose of Big Utility Authorization No. Existing Service Amps I Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampeeity Location and Nature of Proposed Electric Work: J re , C u -T I,S 4 c L r 5 e l il)en Jett f Completion of tha;Wowing table may be waived by the Inspector of Wires No.of Recessed moires No.offFans No.of Total -SQL-(Paddle) Transformers KVA No.of Luminaire Outlets No.of Hot Tubs -Generators KVA Lighting No.of Lam g Pool Above 0 mod- t- Battery Units No.ot Emergency No.of Receptacle Outlets No.of OH Burners FIRE ALARMS No.of Zones No.of Switches o.of Gas Burners Net.of Doh and _ Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Beat t� Number Tons KWDetection/Alerting o Alert Devices No.of Dishwashers Space/Area Heating KW `i oral© MnniriConnection No. Q Other No.ofDryers HeatinbAppliances KW '* Na of�or Equivalent No.of Water No.of No.of Data Wg: Heatersters l irssSys Ballasts No.of Devices or Equivalent 'No. o. Etydromassage Bathtubs !No.of Motors Total HP 1 No.ofDe 'or`uF n OTHER: o Attach add octal detail}'desiired ar as respired ly tkelissp€dor of Wires Estimated Value of wow rJ 5U.- (When required by municipal policy.) Work 10 b _9 )i �s to be requested in accordance with MEC Role 10,and s completion. INSURANCE�GE: Unless waived by the owner,no permit for the perfrnmance of electrical work may issue unless the licensee provides pivof of liability insurance including"completed operation"coverage or its substantial equivalent The undersigned certifies that such coverage is in twee,and has exhibited proof of same to the permit issuing office. CHECK ONE: LNSURANCE X BOND Q OTHER 0 (Specify:) I cert0,uatkr the pains and pis of ps jury,that the inftrinstion an this appEaninn is time and c ompl FIRM N_ r . , LIC.NO.: t (liaPigicab �; rn 6�e�r�e)- Bu&TeL NEt.;�`i _"st- _`'' '1 Address: \. 1 .C CC.7 -Mt ("11�1 h 'i' q O. 3(rC Ate_Tel No.: *Per M.G_L_c.I47,s.57-£s ,security work requ ► ;k-..1, of Public Salty"S License: Lic.No. OWNER'S INSURANCE lit A_tV eht: lam aware that the Licensee does nat here the liability tosurance coverage normally required by taw_ BY Illy side below,I hereby eve this requirement. I am the(cheek one)0 owner 0 owner's scut. Owner/Agent I 1 Sit tutore Tel one No. 1 PST FEE:S 1