HomeMy WebLinkAboutE-21-4004 CommonwealthOfficial Use Only
or
of
et. Massachusetts Permit No. BLDE-21-004004
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:1/20/2021
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) 193 WHITES PATH
Owner or Tenant MID CAPE RACQUET CLUB INC Telephone No.
Owner's Address C/O MAJEWSKI ASSOC INC, 13200 OAKMONT DR, FORT MYERS, FL 33907-8030
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 ❑ 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: Wiring of new tennis court&add sub panel.
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 4 No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires 4 Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting 8
grnd. grnd. Battery Units
No.of Receptacle Outlets 8 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 6 No.of Gas Burners 4 No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. 4 Total 16 No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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 Siens Ballasts 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
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: $1,565.00
(R.�- C o u�c i Vie`. k 1 __
essonsowsse rlassochaistk otoeil use oaiyr^
furies. 2-1 `t(U QL
i '• .... ‘,_ BOARD Cr FIREIa�'!A Occupancy Fee Checked
dame mono
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
d AU woods lobe primed is accordeace with theMaassdnestatHecaenal Code t2 A CtdR O
(PLEASE PRINT IN INK OR TPAIj
ALL / /V .2-I
City or Tows of: vm-i v.l d#rl Tome htspector of Wye:
By this app the undeceived pees notice ofhia or bar' ' to peot=the electrical wash descried below.
Locative(Sweet&Number) L,4-CS a.
Owner or Tenant ► Th c 'e 44- i Q k Tex..
Owner's Address
Is thbt penal is mainadlen will a ieeliig Yes VI N. 0 (Cheek Apple Box)
Perinea of A P ) 1L fir) util r Aniterizaden No.
,,4 MatingSereke Amiss I Yaks Overhead 0 Uair4❑ No.oIMeters
New Stir** OO Asepa 110 i ?°$Veils OVelikeld❑ Uadgrd V3 Nee.dilaters 0
Number eef Feeders and AaeefneNi
1 Leaden and Nature eefPropmd Eleetriad Woes (ji (e 6 'LW k u, 1c[er\ A,J S1,b
Pk 10 _strtir J
WI Ceuspsiesbst reelee11ai9bereUg� ei� he erade�sf lysis�&rpae -ref f
Lik Na of Recessed l.>adaeeieoa Ne.tefCei�-,Saele.Waddle)Fun - 'N� KVA
czl Na et Lareiaaire OMae Nee.of Het Tabs Generation KVA
ea
N..of iaaireieses s--I Nee' ❑ send. 0 Links
et admieney wing `a
No.of lReelptade Ontle a $ No.of OR Barmen FIRE ALARMS IN..ee['T.aletes
Ne.of Sabi Na.of Gee hhhersesse 'l°`W.IMICUNIDXs
11J No.ofil ages No.OM.Coat 14 Totals I1 h Ti{{/0.6 'fieefAle Denim
Pk,.siWaiieBLpoeors Number
Ne.of Dlskwaeekam Space/Area Ragtag KW Local❑ 0 Giber
No.di/ryas Mahe Affirms KWS , Equivalent
No.of Water - 'No.of No.,sd
Heaton Signs Ballasts No.ofDoviess or
Ne►Hyd rommoaBeladanks No.of Mates Tad HP dloas
No.of Dina to or
OTHER:
,,-�11 d d 0,-'" .tawoiratiati ssa1 data14tdts.+ed arm mai e:trydec rcfWi n.
Estimated Value of Electrical wean: 0 of (When by mid policy.)
Work to Stott Inspections to be requested in accordance with MEC Rohe 10,and upon comma
INSURANCE COVERAGE: Unless waived by the mine:,ao peem k for the pereseme oe of electrical work may issue unless
the hide mee provides proofofMobility insurance inchtding°csoteepleted operation"coverage or its subsandial equividest. The
used codifies Bat such coverage Is it form,and has sensed pa of same to the peter issuing office.
CHECK O24NE: INSURANCE la BOND ❑ OTHER 0 (Spoons,)
Jul NNW tiiaepolos asdpeeeoisiec stfpajary,that the isjossosAioet maim appeFaee Iva is ass and completa
• FIRM • . LIC.NO.:
afeeplicable cater M 01rt Sisaatare_ZV-1--tame Mille.$fig$9
Adelrasu e.rS Alt._n Bus.TeL?k.: 17'-3 s7
'Per M.G.L.c.IC,s.57-61,security wart • ofPth&Satyr"S"Liceswed die.No.
OWNER'S INSURANCE WARM I am aware that the Limn does not have the liability insurance anew sena*
required by law. By my signature bolow.I hereby waive this remiement. 1 um the(check me)0 Owner ❑owner's s
Siventere Tekpimme No. I PERMIT FEE;$