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HomeMy WebLinkAboutBlde-18-005443 or Commonwealth of Official Use Only Avattl El RAS Massachusetts Permit No. BLDE-18-005443 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:3/30/2018 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 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Rebar 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 ❑ 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 "',N.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons �•,�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 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: $50.00 -- l Cornnwnwsaith o f t//aaaaeI uesfte Official Use Only Y m �y 0 A-5 4 3 Rev. Permit No. 2 spartinsnt of firs�orvicsb Occupancy1/©7] and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ( (leave blank) x� eb APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC)„527 CM�i 12.00 (PLEASE PRINT IN INK OR TYP ALL INFORMATION) Date: �/2 9 /�' City or Town of: Q,r'1 ate \ To the Inspector of Wires: • By this application the undersigned ives notice of his or her intention to perform the electrical work described below. • Location(Street&Number) Owner or Tenant _ice L OOoZ �� he/r� Telephone No.'8��f�9�-� `n'1 Owner's Address /eR y MQ-/i1 Si- WO/44 l/12 JW 4' ©a V S/ it Is this permit in conjunctio with a building hermit? Yes,®' No E. (Check Appropriate Box) Purpose of Building ( Of l oc/a I Utility Authorization No. d Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps I Volts Overhead 0 Undgrd ❑ No.of Meters • Number of Feeders and Ampacity ` Location and Nature of Proposed Electrical Work: el1(,i`d(np A u-Per -n ro uO1 J .J fir Completion of the followingtable mgbe waived by the Inspector of Wires. f ka No.of Recessed Luminaires No.of Cell.-Soap.(Paddle)Fans Transformers KVA KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA r` t; No.of Luminaires Swimming Pool Above ❑ In- ❑ Bat e y Units Ligh�rng ,� ernd. grnd. Battery Units `� No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones *j No.of Detection and No.of Switches No.of Gas Burners Initiating Devices 1 1f ___�lo..of Ranges No.of Air Cond. Total No.of Alerting Devices w..._....- g Tons ` log of Waste Disposers Heat Pump Number Tons KW *No.of Self-Contained Totals: Detection/Alerting Devices Ui! Y« 1i'Io,of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other °"} ' 1 lalobfD Dryers Heating Appliances KWigeearitySystems:* t ry No.of Devices or Equivalent ,, �, ;� I+io of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or F�uivalent ( ,t ,. '`. f Telecommunications Wiring: ;F` ,l o.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: 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 BOND 0 OTHER ❑ (Specify:) Do wil�► + cwt., / I certify,under the pains and enalties of perjury,that the information on this applicati• is true a ' complete. FIRM NAME: jySd e EIP_cfrira ("onf /: ,diiiv1e.: �} 171q7 Licensee: r Signature /• ,J.: (if applicable,enter"exem t"in the license n ember rn .) , .41 s.Te.No.•.5"Df-77/-77Z7O Address: c37o2 /tl tbtC Q U. /r V Ann A At/4 D0lool Alt.TeL No.:5D8-gV9—9Vb. �i *Per M.G.L.c. 147,s.57-61,security work requires DepixOment of Public Safety"S"License: Lic. No. OWNER'S INSURANCE WAIVER: 1 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 0 owner's a.ent. Own tune PERMIT FEE:$ (���o'I Signature Telephone No.