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Home My WebLink AboutBlde-19-007123 1 Official Use Only Commonwealth of Permit No. BLDE-19-007123Massachusetts 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/N INK OR TYPE ALL INFORMATION) Date:6/19/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perto the electncal work described below. ciA Location(Street&Number) 760 ROUTE 28 . (lab Owner or Tenant DAVENPORT DEWITT P TRS Telephone No. Owner's Address DAVENPORT RLTY TRUST,20 NORTH MAIN ST,SOUTH YARMOUTH, MA 02664 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 ❑ 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: Receptacle in service area,lights in showroom, &sign lighting. 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 5 Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 3 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. 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 ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of 1 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: Robert M Scena Licensee: Robert M Scena Signature LIC.NO.: 21570 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:9 Marilyn Rd,PO BOX 43,Buzzards Bay MA 025323733 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 r Commonwealth //^' 1■ / ofe//(adsachuasffs • Official Use /Only : . !it c�' -(JaParf�narrt o{lira Serviced Permit No. Q ( (Z3 j r_f_ =r BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked {Rev. 1/073 (leave blank) i APPLICATION FOR.PERMIT TO PERFORM - RFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /,'527 1 z.uo City or Town of: YARNIOUTH 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) 7 6 0 /CtF— 0 �- Owner.or Tenant C e GC, ( LT/ w Telephone No. Owner's Address a. ..s.-7 Is this permit.y� in conjunction with a butldin permit? Yet E/No (Check Appropriate Box) \ \�i Purpose of Building y 7'c) _ Ile.-S 4 t vJ )/, Utility Authorization No. r Existing Service Amps / Volts Overhead Q. Undgrd El No.of Meters C..J New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: f n S 7 i atj/ f�c� / i¢d.J. t-w Cie•77`' v 7�/P 7`5 ) ✓7 P r v' C %'�cdS ,i S d'� GIS h7`.5 iv7 S iia 4i-cod �I "st /3 pp c t ,/, , h 7'o Completion of the follawin table m be waived the I o Ye�� No.of Recessed Luminaires No.of Cei1.-S (Paddle)Fans Inspector of Wires. �p No.of Total Transformers KVA _ No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- ZVo.of Ir.mergency Lighting - =rnd ❑ erred. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS [No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices v No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained OTotals: Detection/Alerting Devices v No.of Dishwashers Space/Area Heating KW Local❑ Mupal � Connection ❑ � No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent 0 Heaters ' No Si s Ballasts of No.of Data Wiring: No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommanications Wiring: - No.of Devices or Equivalent OTHER: _ ik Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value f Electrical Work: (When required by municipal policy.) Work to Start: // 41 l/I 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 cove a is in force,and has exhibited proof of same to the permit issuing office. V CHECK ONE: INSURANCE BOA `� OTHER 0 (Specify:) I certify, under the�g ins and penalties ofperjury,p^ thatthe information on this application is true and com lete. w FIRM NAME• Glt'y 1j of SG e✓? cc— P LIC.NO.j—�j"7d 4 Licensee:�Ohe. f (If applicable, t '��G Signature LIC.NO.: yv y er�gemp the license tuber line.) Address: �� (� 4>Q� �' cR�,S L�� 0 2 5.j1 rt 7 Bus.Tel.No.: g'�7 .J *Per M.G. C. 147,s.57-61,security work requires Department of Public SafetyAft.Tel.No.: — OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liabilityLin.No. � insurance coverage normally required by law. By my signature below,I hereby waive this requirement I am the(check one 0 owner o Owner/Agent ❑owner's a en lISignature - Telephone No. . PERMIT FEE: $