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HomeMy WebLinkAboutBLDE-22-006454 '`'" Commonwealth of Official Use Only �+ Massachusetts Permit No BLDE-22-006454 17:::§ BOARD OF FIRE PREVENTION REGU LATIONS Occupancy and Fee Checked 1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL W All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of: YARMOUTH Date:To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to performthe electrical work described below. Location(Street&Number) 91 WILLOW ST Owner or Tenant NINETY ONE WILLOW REAL ESTATE LLC Owner's Address C/O MILL LANE MANAGEMENT INC, 231 WILLOW ST, YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Existing Service Amps Utility Authorization No. p Volts Overhead 0 Undgrd 0 New ServicegNo.of Meters Amps Volts Overhead 0 0 Undgrd Number of Feeders and Ampacity gNo.of Meters Location and Nature of Proposed Electrical Work: wiring for 3 NC units. (I.F.A.W.) Completion of the following table may be waived by the Inspector of Wires. I No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Transformers Total KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- grnd. ❑ grnd. ❑ No.of Emergency Lighting Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and No.of Ranges Initiating Devices No.of Air Cond. 3 Total Tons No.of Alerting Devices Heat Pump Number KW No.of Self-Contained No.of Waste Disposers Totals: - No.of Dishwashers Detection/Alertin, Devices Space/Area Heating KW Local 0 Municipal No.of Dryers Connection ID Other: Heating Appliances KW Security Systems:* No.of Water KW No.of No.of Devices or E•uivalent leaters No. No.of Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Devices or E 1 uivalent No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E i uivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work to start: (When required by municipal policy.) 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 :) I certify,under the pains and penalties operjury,that the information❑ ion this application istrue and complete. FIRM NAME: ROBERT E BOWDOIN Licensee: Robert E Bowdoin Signature Tel. NO.:.: 51981 (Ifapplicable,enter"exempt"ira the license number tine.) Address:502 PITCHERS WAY, HYANNIS MA 026012582 M.Tel.No.: 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 Owner/Agent ) 0 owner 0 owner's agent. Signature Telephone No. PERMIT FEE: $80.00 s Conimo lth oil///otiveLe — , offal Use only . �` 1 = cc�� cc�7 ��JJ J a 1Jepar/ine o�}rre—coked No. E' -V.3 � �  s� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ?.�.a• 'ev. 1/07] Leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL All work to be performed in accordance with the Massachusetts Electrical Code WORK (PLEASE PRINT IN INK OR TYPEALL INFORMATIOIIN Date: C),5 CMR 12.00 City or Town of S J �'� �';_i. i\1( f- . ) To the Inspector of Wires: By this application the undersigned gives notice of his qr her intention to -j i LAJ i f OW 5+perform the electrical work described below. Location(Street&Number) ` Owner or Tenant r 0 Owner's Address /m 6 Telephone No.,jt, • 7-5�5Y Is this permit in conjunction with a buildingWr° �� permit? Yes NO (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead New Service Amps0 Undgrd El No.of Meters IVolts Overhead❑ Untlgrd Number of Feeders and Ampacity ❑ No.of Meters Location and Nature of Proposed Electrical Work: ` No.of R Cam.letion, the ollowi _table may be waived, the I ,,-cror o Wires. Recessed Luminaires No.of CeiL-S No.of �p !Paddle)Fans Transformers Total No.of Luminaire Outlets KVA No.of Hot Tubs Generators KVA No.of Luminaires Above ln_ Swimming Pool a ,d. ❑ a ; rgency g, „ g No.of Receptacle Outlets � Butte Units No.of Oil Burners No.of Switches FIRE ALARMS No.of Zones No of Gas Burners No.of Detection and No.of Ranges Lich, , . Devices No.of Air Cond.3 No.of Alerting Devices No.of Waste Disposers Heat Pump um, r ous� Totals: -_ No.o -1 ontained No.of Dishwashers Detection/Alerbu.Devices a Space/Area Heating KW nnici l No.of Dryersfocal❑ Connection 0 other Heating Appliances ICW Security stems:* o.of Water No.of No.of Devices or , KW No.of wvalent Si J,s Ballasts Data Wiring: ivo.t yd Heatersage Bathtubs No.of Devices or E,nivalent No.of Motors Tclecommiz icz om Wiring: Total HP OTHER: No.of Devices or E,nivalent Estimated Value of F.! Attach additional derail Varesirect Work .3 0 00.E° (Whenrequired or as required by the Inspector of Wires. Work to Start 6 to ��- I by municipal policy.) INSURANCE CO moons to be requested in accordance with MEC Rule 10,and u INSURANCE E CO GE: Unless waived by the owner,no permit for the performance of electrical issue��pleti the licensedpovi certifies such isbility insurance including"completed operation" may n. Th unless �P coverageth or its issuing substantial uivalent. The CHECK ONE: INgT1RgNCE coverage is in force,and has exhibited proof of same to the permit BOND 0 OTHER 0 (Specify:) office. I certify,under the pains FIRM NAME: penai€;es©fperjsn ,that the information on this application is true and complete. Licensee: LIC.NO.: ---� , Licensee: ceble enter „rtt the license'�-L t !1'i Signature ` l Address: member time.) IdG NU.: *Per ass: .c.147,s_57{,l Bus.Tel No.: t y-3La-C -I(' � OWNER'S INSURANCE WAIVER:tywork requires Department of Public SafetyAlt.Tel.No.: -------- OWNER'S law. I am aware that the Licensee does not hLl Lt'c.No. By my signature below,I herebythe liability insurance -----_... requiredcoverage normally ally Owner/Agent waive this requirement_ I am the(cheek )o owner Signature ❑owner's agent. Telephone No. PERMIT FEE:$ -- _