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HomeMy WebLinkAboutBLDE-21-004638 Commonwealth of Official Use Only tfil Massachusetts Permit No. BLDE-21-004638 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:2/16/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 48 GRANDVIEW DR Owner or Tenant POLLEY ELAINE C TR Telephone No. Owner's Address THE ELAINE C POLLEY FAMILY TRUST,48 GRANDVIEW DR, SOUTH YARMOUTH, MA 02664 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Split A/C system. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting No.of Luminaires grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and No.of Switches Initiatine Devices No.of Air Cond. 1 Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Municipal ❑ Other: No.of Dishwashers Space/Area Heating KW Local ❑ Connection Security Systems:* No.of Dryers Heating Appliances KW Security of Devices or Equivalent No.of Water No.of No.of Data Wiring: KW Signs Ballasts No.of Devices or Equivalent Heaters Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 LIC.NO.: 51981 Licensee: Robert E Bowdoin Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: o. Address:502 PITCHERS WAY, HYANNIS MA 026012582 *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 othe liability ner in owner'rance csoverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) t. Owner/Agent PERMIT FEE: $50.00 Telephone No. Signature ok. C 4 (Al/. Official Use CM1y - No. — (k(o 6 ie t -�c�wt�� *swam seed coed r APPLICATION WORK clAN we&se beperforeted insoDetdence via en tut t?..os Cyr for Town et yar-onoirril lb the Inspector ofWre4: By thie application da undoesteed gives notice orbitsocher inicetionte pause die decided eai w+ask&stand fir_ Leese*greet&l Li g '(2 'r i e c��l Y \c_- coat Teague � r-f-` i V►n p t\ Tektapae 5of-I„la--0iD__ 4 Owner's Address / Is a Ye 0 No 0 Awrephde z } mat No. r I Y 0 0 Pie.eel ?Maher alined=and Asassedy Ayes I vat Oveybead 0 0 No.*Meters Lowden sod Mimeo af?e+eteeeed Madrid Work: WI fe Al tbish, c4u&Q__- rn e..-. e WI vt - Coewlemene'ilie mtr ►e ,ri► =torefii Ns.elfReeeseed laankaatree Pia.eftkip.Snep (radial Fosstif Trambrakers KVA C No.al °Wets No.@MHetTide KYA No.ef 0 Ia. 0 it&at Enteressey uplift Na ollinceptode t 'Naef©11Burners rNRE ALARMS 1No.ofZones No.*Wm lasers ' hoodkurpewkse to No. No.et A Coed. Thi of Martha DMus i Pio.oftWastolibpasers Kent Pomp 11104V a U. se 'ummut! We.orDisintasbers SpaesiAna Beetrag KW haata k 0 Met , -Na.of Dern Heating Appanage KW lifelwaY- iiWarWaer KW Ns'lf Me.el DNS Widow Heaters SOB BMWs No. a No.of M 1� No.ofPio.orDeskesar Amok magma I Awn embalm&arosniipdiredigrilositispacturgrartres. Eninneed Value efElecnisat Work (Whoa terpired b asseicipd it l WOrktO Matt hapectioisto be oxpested imeoutiowe wa MEC Rule l0,and upon conviction. INSURANat{OVERAGE1 Unless waked by the owner.ao punk kwthe perffineanee o(deet icet mar issue unless the ikonsee prides1 w meow arm The ineletsigned oestrus Set soak cannon is in three,endued af'snob to tie porn&issuingoffice. CHECK t 4E: DaSURANCE 0 NM 0 mita t3 Its war the1 + 'P me Oa appicestim he tesa and FIRM fide. a M.G,L t«147,&5741,swanky wodcropthis a Y,i.4:,.- ofP "S"Lieenew Lit.Nc OVilinIS DMAN{=WANE& I an tint de Limn does not hawthe Milky imam cower=malty By ou eigutote balm.I by widget&tegoiremitM1mai e(thark me)0 maw 0 emsees await.