HomeMy WebLinkAboutBlde-19-002227 Commonwealth of Official Use Only
�E Massachusetts Permit No. BLDE-19-002227
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:10/15/2018
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 electrical work described below.
Location(Street&Number) 881 ROUTE 28
Owner or Tenant GREEN CAVALIER LLC Telephone No.
Owner's Address 111 HUNTINGTON AVE#600, BOSTON, MA 02199
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:
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 ❑ 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
Initiating Devices
"''i.of Ranges .No.of Air Cond. otal No.of Alerting Devices
4+.d.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 Signs 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: Arthur P Doherty
Licensee: Arthur P Doherty Signature LIC.NO.: 17197
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:372 YARMOUTH RD, HYANNIS MA 026012043 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
, ature Telephone No. PERMIT FEE:$480.00
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Official ijsc 'nlyj
•A f M ft Permit No.
spartment ol...tirs&raced
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /D///.//$'
v City or Town of: arM D!Oh To the Inspector of Wires:
By this application the undersigned�gives notice of his or her intention to perform the electrical work described below.
NLocation(Street&Number) R8'/ ,t jL1. of
Owner or Tenant I C! L,-G Telephone No.
•.. Owner's Address O a2
Is this permit in conjunction with a b tiding permit? Yes 0 No ❑ (Check Ap a
Purpose of Building COmwlere la,{ Utility Authorization No.IZtli
Existing Service Amps / Volts Overhead❑ Undgrd El No.of ritRifs 1 1 2018
N New Service Amps / Volts Overhead El Undgrd❑ No.of Meters�_- —
Number of Feeders and Ampacity 1.1 I L1)1 t 4. .)E P I
Location and Nature of Proposed Electrical Work: SIB /i( Jr t'I nc/ — 40 i n CFI Gh VII 5
Completion of the followingtable mom'be waived by the fnpector of Wires.
Total
Qi No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No. f
Trano KVAsformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Above In- No.of Emergency Lighting
No.of Luminaires Swimming Pool grad. ❑ grnd. ❑ Battery Units
g No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners 'No.
of Detectionand
Initiatinngg Devices
i-= No.of Ranges No.of Air Cond. Toast No.of Alerting Devices
No.of Waste Disposers Hear Pump number Tons KW "No.of Detection/Alerting Self-Contained
Devices
No.of Dishwashers Space/Area Heating KW Local❑ Connectionipal
❑ Other
Cyyonnection
No.of Dryers Heating Appliances KWSeCNo of Devictes or Equivalent
No.o3'Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or communic Equivalent
tions No.Hydromassage Bathtubs No.of Motors Total HP Tel No.of Devic s 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: Inspections 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)1 BOND 0 OTHER ❑ (Specify:) JQw/i, 4 01--0 We.,7
I certify,under the pains and penalties of perjury,that the information on tins appl ccadon is true and complete.
FIRM NAME: r '•.e - c.-`-l"t C4_J . r, r- , 4 O.: A I7117
Licensee: A %A l- '}, bpi,e.r4-./ fir' Signatu��i ^'��fl r/�. O.•
(If applicable,enter'"exempt"in the license nt mber line.) / s. ' .No„SO e-177J-1oZ70
Address: 37 a- ' O.rw.o tL+k tQ.a 14 y 0O,in I1 I S MA- O 2 to / 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)0 owner 0 owner's agent.
Owner/Agent Signature Telephone No. PERMIT FEE:$ 4p 00
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