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Home My WebLink AboutBLDE-19-3372 Commonwealth of Official Use Only v ...*',►�\ Massachusetts Permit No. BLDE-19-003372 E.•011;;;\ 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:12/4/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertonn the electrical work described below. Location(Street&Number) 5 CARRIAGE LN Owner or Tenant SANDY SIDE CORP Telephone No. Owner's Address P 0 BOX 525,YARMOUTH PORT, MA 02675 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 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Re-bar grounding. 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 0 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 Initiatin¢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/Alertinc 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 , 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 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 ❑ 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: Lance A Macenemey Licensee: Lance A Macenemey Signature LIC.NO.: 11149 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 126A MID TECH DR,W YARMOUTH MA 026732560 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 pp m� Official Use 1 Commonwealth o�/r/adeac�euehl — � ✓ / c7 Permit No. �l:m'� s �eParimeni o`.tire Serviced r a,_�{ se Occupancy and Fee Checked j r BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) J `i APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK '-''a 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: 12.13 lib %) City or Town of: yQImpa To the Inspector of Wires: y By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 5 C s- okp I. .nt_ Ct^ Owner or Tenant ]'n4C Aja /1m re (12_610ertQ7 Telephone No. W Owner's Address A 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❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity CC n 1 Location and Nature of Proposed Electrical Work: t3 nd i h Q cD c. Sf€.` 4 - A I or Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf T Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting Arnd. 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 Detectionnand Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained P Totals: " — Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal ❑ Other❑ Connection No.of Dryers Heating Appliances Kms, SecuriNo s:* of Device s or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts —No.-of-Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Tel o�fmgfviIres ot'rEgeivalent OTHER: orgy' tp( ,� Attach additional detail ifdese ed,IIorhS queS'Erfb, t7inJspeccurofWires. Estimated Value of Electrical Work: (When required by municipal policy)__. J Work to Start: Inspections to be requested in accordance with MEC { ,VI11{dhftbltlpletio . INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance&nen ernay-isLue 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�r� pains and enalties ofperjuty,that the information on this application is true and complete 1 A FIRM NAME: F-t.1e r 4(ee+rk ConQA ry J LIC.NO.: A 1'(1'VI Licensee: �(Aylp,p` '#1' f ne(feySignature �� LIC.NO.: t &applicable,enter "exempt;the Ice number li e. Bus.Tel.No..(50 )71 c-003u Address: I(oA m id to c_( r .�exrrs.nu+6 Alt.Tel.No.: - *Per M.G.L.c. 147,s.57-61,security work requires 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 required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/AgentPERMIT FEE:$ 50.00 SignatureturaTelephone No.