HomeMy WebLinkAboutBLDE-21-004641 Commonwealth of Official Use Only
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Massachusetts Permit No. BLDE-21-004641
......-- 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) 91 DRIVING TEE CIR
Owner or Tenant John Pauly Telephone No.
Owner's Address 91 DRIVING TEE CIR, SOUTH YARMOUTH, MA 02664-2115
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 ❑ i eters
New Service Amps Volts Overhead 0 Undgrd 0 'o. 1 1
Number of Feeders and Ampacity Q
Location and Nature of Proposed Electrical Work: Central A/C system.
,-PfO
Completion of the following table y b i •. e8p •. of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of 4. alTransformers VA
No.of Luminaire Outlets No.of Hot Tubs Generators �� L: A
No.of Luminaires Swimming Pool Abode grad. 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
Initiating Devices
No.of Ranges No.of Air Cond. 1 Total 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 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 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: $50.00
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APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
AU work to be panned in accardance vrith ihe Mastneintgeits Elecnind Code NEM,527 Mgt 1200
\E (P L E A S E PRINTTIN MOB 77..DIFORAil Date:
c,,,i,11270110_
To the lwector of Wines:
By this application the undonitiod ghettos*ofhis 4N bar inigartion to perform elm electrical weak clescnird below.
Lecato n( tta&Neinther) ci 1 f) i C
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Teletthane Nu-csit-C F7/
Owner arinamet -- -3()hn "17-b.i 1 TV
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thoodes Adam 7
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The&
..,.1 Is thisp ioeraitrasisocaravella olralliosporsir 'is 0No 0Apprope gez)
;; Purposonfollgi " 1:101y Antborkadon No.
, &iatinstiervka• imp I Volts Ombenti 0 Usoligni 0 No.of Alden —
No.of Meters
--",t,1 New Sowin AUDI i Vats threrhead 0 Uragrd 0
-\'''''42------
-•?si, Namara of FoodonavolAsesdir
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------ : Locadis awl Notisserantwagssinalondhavil WoM VI i ce C/ C----
.
P Cvamittentsfitto &Mem s i g rhawaind, ittelowegiorof Wes.
I ar fotol
a ontecossedlorainaices No.alTelloliasp.OWN.Para ....11.-aue&s KVA
KVA
4 of Iradrake Ondtato No.tinier Tabs
Above r-t In- In l et glinerlies7 lAglinat
oliandwaket Swimming Pool g LI nwi. El t. _ units
'4.... oninteaptacle thatiets Me.of Olt Burners - i•i--ALARMS INe.enema
-V ' CIANctio st.
...N. • dSwItion No.deft Posen
,4.
Total
, of Aterthmi Dodoes
IV ,- entrails No.of Air Cost Tons
alWasiolftemera Eleationgs rosiber rens IKW - ofpc150moramit
; - -• -- ,- Boalso
4.E-•...
ef Bkinendara Spae/Area Beating KW- - E3 iv - . 0 Ober
No.aflisyers ,Beating Appliances KW -1410.412*.ir Eastratent
ofWidar W7-- No.of ; = Whinv
Horan KW sag Boasts
No.Hydresessige Bathtubs No.of Meters Total BP No.*Merkel or
OTHER: -
Attack addir.212' al dawil Vdttatted cr.=refednodi90 shelffesPizavr 0391 -
Es6mated Va of Ekoim'cal Work (When reviled by 1131MiC41121 policy.)
Work to Start impections to be repented in accordm 's i t I a t I E C bin 10,mui upon conplelion,
INSURANCE COVERAGE: Uniess waived by the owner,no permit for the perflinnance of electrical work may issue-unless
the licensee Rovidoo proof of May imam=including"completed wartlike caverap orbs substrate' equivalent The
undersigaed‘ettifael,that such coverage is in force,and has exhibited proof of saine to the permit issuing office.
CHECK ONE: INSURANCE El BOND 0 OTHER 0 (Specifi )
/moat wk.thepaks e m 1 ftesmites ilperjwy,limo the ityltrtntlettx on this 4t;"IS&SE nod amokoa
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LI*-- -. -k-li" -•-•- 1---M="617-1---Signatiarl— ucxmLISIGIVIf afgasikak otter" v- &me snasgmr i Rae.) - Bies.111.Not.1 7 7V-3i2f-071>1
Adams= ei** . Kite,. Oil
Att Tel.Nea'Per Mal-u•147,s.57-61,sesnaity weik - DqAuteg of Public Sisfety"S"lir-A.1w- Lit_Na.
OWNER'S litNNIANa{WAS I am aware that the Licensee dues not*tape the liability ram=coverage normally
rapist by w. By my'behow.I hateby waive this texplirettentI am the(cheek one)0 owner aswenees agent
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