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Home My WebLink AboutBLDE-23-000748 Commonwealth of official Use Only C ceoi' Massachusetts Permit No. BLDE-23-000748 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:8/15/2022 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) 39 GROUSE LN Owner or Tenant Glen Stagnitta Telephone No. Owner's Address 39 GROUSE LN,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) i,/,/ Purpose of Building Utility Authorization No. ' Existing Service Amps Volts Overhead ❑ 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: Central A/C system 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. 1 Ton l No.of Alerting Devices 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 ❑ 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 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:) . 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 1,?Anta- 6 kiptif - e"o r mop, istia,A) 7l (7, Chi ssAmP ,.,, ,,i0 ttsmotatueanh of Naoackaetii ..efl Use _y_I --- _= Permit No. 't/ �r a t _St o are ervicse 2� lgi s 10 ' Occupancy and Fee Checked - =-� BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) ey a APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All cork to be performed in accordance (PLEASE PRINT IN INK OR TYPE,A4 INFORMATION) Date: re )3 3— To the I ctor ofWires: City or Town of: Gi M[;'� By this application the undersigned gives notice of his or her intentionto perform the electrical work described below. Location(Street&Number).c1 �C:cc u ),C'__- l ► )e G C� 11�� Owner or Tenant �l("',� r 5 r i'rc n s-�I,Sn) fl—Cf Telephone No.? IS - `r Owner's Address (/ Is this permit in conjunction with a building permit? Yes I I No I' 'I (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps Volts Overhead I I Undgrd( I No.of Meters Number of Feeders and Ampacity 1 _ Location and Nature of Proposed Electrical Work: '` - 1( C,14C __ 4/(- iis-}t�� Completion of the followingjable may be waived by the Inspector of Wires.I No.of Total 1 No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool gm, gl nd, ❑ Battery Units _ rs FIRE ALARMS INo.of Zones No.of Oil Burners No.of Receptacle Outlets No.of Detection and s No.of Switches No.of Gas Burners Initiating Devices 3 Total No.of Alerting Devices No.of Ranges No.of Air Cond. Tons Heat PumpI Number Tons 1 KW No.of Self-Contained `Detection/Alerting Devices No_of Waste Disposers Totals: S ace/Area Heating KW Local❑ Municipal Connection ❑ Ql�er No of Dishwashers p Security Systems:' No.of Dryers Heating Appliances KW No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: KW Ballasts No.of Devices or Equivalent Heaters Signs Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: C3 00 Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lectrical Work: a/. -- (When required by municipal policy.) Work to Start: C Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 cernfy,under the pains and penalties of perjury,that the information on tit' application is true and L complete. FIRM NAME: _ � LIC_NO.:t j I - l� Licensee: 1&b c f" E P)O LL; C�c t r) Signature ' $ ,LI No:_.16 i 3 6�+ / 7 A applicable,a V-C•74 .n► l ' 4rj l ii 1 rr� L---4- kJ C% Alt.TeL No.: Address: ( t�<%� u CC�1 tt -1 Olt: �t I 1� *Per M.G.L.c. 147,s.5741,security work requires Depf3r1ment 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 taw. By my signature below,I hem-by waive this requirement. I am the(check one)0 owner ❑owner's agent. Owner/Agent Telephone No. i PERMIT FEE: Signature S i