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Home My WebLink AboutE-19-2468 • d- Commonwealth ofOfficial Use Only ' i Massachusetts Permit No. BLDE-19-002468 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.1/073 - 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:10/25/2018 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 decimal work describbelow. Location(Street&Number) 11 ATLANTIC AVE42-/10-12/17" 10 C e7t- Owner or Tenant VIRTOM LIMITED PARTNERSHIP Telephone No. Owner's Address 2 ATLANTIC AVE, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (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 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install 6-220 volt& 1-120 volt receptacles. Completion of the following table maybe 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 v KVA No.of Luminaires Swimming Pool Above ❑ Igor; ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 8 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 3 No.of Gas Burners No.of Detection and Initiating 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: 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 Stens 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 fdesired,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: MICHAEL T HINCKLEY Licensee: Michael T Hinckley Signature LIC.NO.: 50356 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:73 BARBERRY LN, MARSTONS MLS MA 026481908 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:$80.00 ✓ - . p .. __ l�ommorw OS of///ai4ac rte otr;aial Use Oni ski JJsPartmst�(of Jtn._cervices No.(�' Ij l V k .1, Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS . I/01 ' (leave blank) 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: /0-gs-a City or Town of: YARMOUTH To Me Inspector of Wires: . By this application the pndersigned gives notice of his or her intention to perform the electrical work described below. • Location (Street&Number) // ATLAM1ti Ave OwnerorTenant !Rohde- D62O5,Ct'L— nnerLT ecoit75 Telephone No. � Owner's Address �� e. Is this permit in conjunction with a building permit? Yes 0 No xi (Check Appropriate Box) itillt Purpose of Building CoNgef_tat L WOtt S ii0 Utility Authorization No. Existing Service /DO Amps 110/ TO Volts Overhead 0 Undgrd❑ No.of Meters / t-- .ew Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters o w tuber of Feeders and Ampacity 7 a don and Nature of Proposed Electrical Work: 4Di b v .=,.0 nimp laetep rnter5 a,vb _ �`n W b<,c f tO j c11ew1 Re v71 t 11Y Qoewf I is Gil ui Completion ofthe following table may be waived by the Inspector of Wires. U cO N .of Recessed Luminaires No.of Cell-S No.of Total z nap.(Paddle)Fans • Transformers KVA W �O •N N .of Luminaire Outlets\.....----------7No.of Hot Tubs Generators KVA 7 ` of Luminaires Swimming Pool Above ❑ its- No.of Emergency Lighting - Erred Erol ❑ Battery Units No.of Receptacle Outlets 0/ 8 No.of OB Burners FIRE ALARMS INo.of Zones No.of Switches v No.of Gas Burners No.of Detection and Initiating Devices ToNo.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump'Number I Tons I KW No.of Self Contained ' Totals: Detettion/Alerting Device No.of Dishwashers Space/Area HeatingKWMunicipal ' Leal❑Connection 0 Other No.of Dryers Heating Appliances Kw Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring I Signs Ballasts No.of Devices or Eqdivalent - No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent lb OTHER: _ Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: i (When required by municipal policy.) Work to Start: R /0'35"� Inspections to be requested in accordance with MEC Rule 10,and upon completion. Ca 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 ,Z} BOND 0 OTHER 0 (Specify:) I certify, under the pains and penalties99� of perjury,that the information on this application is true and complete.. FIRM NAME: Mioihtar I .1t10Cl cq LIC.NO.:: $D 6G6 Licensee: ICNAt2% /�tNu4e`/ Signature / LIC.NO. (If applicable,enter"exempt"in the(item number line.) �5D,3�56C: Address 73 13At1)r�r¢t� L bull MAthroas ,tlleLSJt(A Od41(S Bus.TeL No.: -77t/-3G5-0347 work requiresAlt.Tel.No.: . l ily j Per M.G.L.c. 147,s.57-61,security Department 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 icrequired by law. By my signature below,I hereby waive this requirement I am the(check one)❑owner 0 owner's ag eat, t Owner/Agent Signature• Telephone No. ( PERMIT FEE: $ Opt/}