HomeMy WebLinkAboutBLDE-22-004066 Commonwealth of 0Official Use Only
'fL. Massachusetts Permit No. BLDE-22-004066
`C�' 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 Massachusctts Electrical Code (MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:1/24/2022
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) 25 PHEASANT COVE CIR
Owner or Tenant DOWNEY MARY C Telephone No.
Owner's Address 840 BRONX RIVER RD, BRONXVILLE, NY 10708-7070
Is this permit in conjunction with a building permit? Yes 0 No 0 (Cheptoprfpte,);ox)
° ` >``\
Purpose of Building Utility Authorization No`. �;�
Existing Service Amps Volts Overhead 0 Undgrd 0 "lip r�
New Service Amps Volts Overhead ID Undgrd 0
e
Number of Feeders and Ampacity �7
Location and Nature of Proposed Electrical Work: Vehicle charging station Q a
Completion of the following table miry e , .1 • e pector of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total
p Transformers / Q 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
lnitiatine 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 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 ,Siens No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Eauivalent
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:
Licensee: JEFFREY ROBERT GREENWWOD Signature LIC.NO.: 22826
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 16 MARAVISTA AVE,TEATICKET MA 02536 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
pp`` M Official Use Only
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o Services'= Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS I[Rev. 1/071 (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: 01/11/22
Yarmouth port
City or Town of: 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)25 Pheasant cove circle
Owner or Tenant Maggie SbWney Telephone No5087373774
Owner's Address Z5 iheasant Cove circle. Yarmouth port, MA 02675
Is this permit in conjunction with a building permit? Yes lj No ❑ (Check Appropriate Box)
Purpose of Building Residential 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
Location and Nature of Proposed Electrical V1'orl.installation of a Charge Point Home Flex electric vehicle
charger up to 50amp. 240 v
Completion of the following table may be waived by the Inspector of Wires.
NoNo.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tr of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
ovNo.of Luminaires Swimming Pool g d e LJ grnd. ❑ Battery UnitsQncy Lighting
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
of
No.of Switches No.of Gas Burners No. InDete and
Initiatinnggon 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:I Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ pal Munici ❑ Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications wring:
No.of Devices or Equivalent
OTHER:
$2,000 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:01.18.22 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 iir BOND ❑ OTHER El (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Cotuit Solar LLC LIC.NO.: 22826-A
Licensee: Jeffrey Robert Greenwood Signatui k , _.z = LIC. NO.:
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No. 508-428-8442
Address: P.O. Box 89. Cotuit. MA 02635 Alt.Tel.No.: 50R-54fl-4474
*Per M.G.L. c. 147, s. 57-61,security work requires Department of Public Safety"S"License: Lie.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally 8
required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. i
Owner/Agent 1 i - "
PERMIT
FEE: $
Signature Telephone No. Ii