BLDE-23-004828 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-23-004828
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:3/2/2023
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: install 4 temps electric heat blower, 1 duplex in attic,3 GFI on panel
(508-364-8456)
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
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 Siuns 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 perjuly,that the information on this application is true and complete.
FIRM NAME: DAVID E COLEMAN
Licensee: David E Coleman Signature LIC.NO.: 29607
(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: $100.00
E 1 V Official Use Only
Commonwealthof f aeeac _
l — ,l eL3e ailment o }ire 7 (\ Q 2 2023 erntit No. _ �%,l 2J - G�U�� �
t:f t_I p y cctl anc and Fee Checked
=
'�„ter BOARD OF FIRE PREVENTION F TI QN Tn�deg. 'p)7]y (leave blank)
APPLICATION FOR PERMIT 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: ,2/.7
City or Town of: 4) 4 v�,!4 To the Ins ctorro Wires:
� f
By this application the undersigned givenotice of his or her intention to perform the electrical work described below.
Location(Street&Number) ? t3 0 l t} ,s pfL i j 4 /4„y..1_,
Owner or Tenant ., T r t= FE pa q? Telephone No.
Owner's Address s 1Ce?�1.e?. 6
E
Is this permit in conjunction with a building permit? Yes L No id (Check Appropriate Box)
[ Purpose of Buildings t .st�s'�,� • Utility Authorization No.
Existing Service Amps / VI olts Overhead Undgrd __. No.of Meters
E New Service Amps / Volts Overhead E Undgrd E No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: j.4? ,s'.s ,ia e ®j/ ;j�.,. ,, 4740 c- 4„4 /Ve,,
)3/6,4 ''r / ?c'P)„t-�. /nil ii j i - le' -3 6I 1 fZ C..e et°e'. O4 '' '...
3 t' AT 1�'a>® I c c k / .� a0A..t<f.. °'�a e,,.c.C'ornpletion of the following table may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tf
Transformers KVA
f No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grad. grad. Battery Units
No.of Receptacle Outlets 3 No.of OIl Burners FIRE ALARMS No.of Zones
of
No.of Switches No.of Gas Burners No. Inittiatiiati gon and
Inng Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
g Tons
d
No.of Waste Disposers Heat Pump to p Number Tons KW Detection/Alerting o.of Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other
Connection
No.of Dryers Heating Appliances KW 'Security Systems:*
r 3 No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications NofDevices
or qu Wiring:
Y g No.of Devices Equivalent
OTHER: 7,-, C -31'. 7 rry .. Z. . s,, �a`u ..Wu
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: ,,,, ?, `-=- 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 coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE] BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
,
FIRM NAME: ee0 l '1-.0s,.®�ao /5/ee j 4 4, ..,4.0',... LIC.NO.: jG..?94,a 7
Licensee: 1!Jc.i r , '=a/,,of.,,,z,.. Signature Aj1, f LIC.NO.: #041i7-3A /
(If applicable, enter "exempt"in the license number line.) Bus.Tel.No.: :S?I -3t.'1
Address: hpJ°/.E r Le® ®I A /o>' 4 z/ :"1 .5 /9Pia e.,.)e,y Alt.Tel.No.: 8 -4
`Per M.G.L.c. 147,s. 57-61,security work requires Department 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.
OwnerlAgent PERMIT FEE: $
Signature Telephone No.
1
I Caleb Cook,electrician journeyman license number 58839— B, completed a meg test at 9 Bowsprit Path
West Yarmouth, MA on July 19, 2023
Signed:
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