HomeMy WebLinkAboutBLDE-23-005877 Commonwealth of Official Use Only
0Massachusetts Permit No. BLDE-23-005877
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/N INK OR TYPE ALL INFORMATION) Date:4/24/2023
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) 105 POND ST
Owner or Tenant JOANN CONEYS Telephone No.
Owner's Address
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 'z
40,
New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters t
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Replacement boiler&wiring for heat pump.
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 1 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: 1 Detection/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local ❑ 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 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: $50.00
111.111.1111.1...
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amp pevnitNo. 3 , p0y�
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inetAff BOARD Of FIRE PREVENTIONREGULATIONS My) Im.e amk
E 'rROLT ex-,sr IC AL WORK
TO PERFORM c .2.oa
APPLICA ON P dw Mouton wito Etoenten Date: E I et -.3
Ail woh to tie E ALL/IVFORMATIONI To the 1nsPect of Wires:
ININKORTY. bek'w.
(PLEASE PRINT YYa('yvt or ������,the eleeuical"'°h��
or Town of: ut o Lb
By
chi.grplicaoon the.mde+aia°�we.'�0 -f'ee.'1' Telepboae No.f..�J-
Owner
o(Sheet L�Neatber) ne.
Owner or TomeN �' '' (Cheek Appropriate Bost
owaer't Addr a Yea NO
Heir to relJe•cN �aa wits•betldlaa P Util .Authorization No.
Is lib permit No.of Meters
Porpo•e of Bendlea Ova�e.d 0 Undfird❑
olts
isa5 Ann" --/--'V overlies,'0 Uadard CI No-of MetersAspt _Volt Feeders gad A®Patity I o l 6 6.- c"4" ' S i 1.1
Homier of dNatE(ectrlwl work o i
[,°ratloe and Nature of P1 kj c-d M be wahrcd• the/n••-,to
C .l ion a the ollow•Im table in.'
No.of Recessed Laminafres
CriCEE ra:2211111111121111111
No.of Lttmleatr Chokese tleChokes ❑ ., d. ❑ '
a 7,v
e
Swimming Pool ,, ,d. �;'���
alecamme
No.arR•°rPtxt•t No.of Oil Barren 'o aWia t et Ala—
Initiatin Devices
No.of Alerting Devices
Detection/Ale Devices
Na of Wade Dbposers un!Mr" Other
Local❑Connection
Na of Dbitrasben 0
n yystems:
Heating Appliances KW Na of Devices or '•nivalent
No.of Dryers `o.o Data Wiry:
HeatersKW °'Signs Ballasts Na of Devices or '•aivalent
No.Hydromunge Bathtubs No.of Motor Total HP No.of Devices or ' aiv nt
OTHER
'. ac- Attach additional detail Tdestred.or as required by the Inspector of Wires.
Estimated Value f E •al Work: t•-•-'• ': (When required by municipal policy.)
Work to Start:�f1I yt/e/�a c3 ... dons •be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE¢OVERAGE: 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'certO,under the pains and penalties of perjury,That Ike information on this application is true and complete.
FIRM NAME: LIC.NO.:
Licensee: eri!-Et�Ola *pours l LIC.NO.:5' (9 8I C
Wappl/wb 'hem m e*ens ) Bag TeL No:�1 '3f,g-0
Address: 0 L_Q lioDh �enx>c.r ,Alit a 3 r,e Alt.TeL Na:
'Per M.G.L.c.147,s 7-61,security work Department of Public Safety"S"License: Lie.No.
OWNER'S INS! NCB WAIVER: lam aware that the Licensee does not have the liability insure' we coverage normally
requited by law. By my signature below,!hereby waive this requirement. 1 am the(check one)0 owner ❑owner's agent.
Owner/Agent
Signature Telephone No. 1 PERMIT FEE:$ 1