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HomeMy WebLinkAboutBlde-19-005751 a Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-005751 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:4/16/2019 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) 476 ROUTE 28 Owner or Tenant THE POINT LLC Telephone No. Owner's Address 476 ROUTE 28,WEST YARMOUTH, MA 02673 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: Replace septic control panel.(Line voltage by others) 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 Initiatinu Devices No.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 ❑ 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 Siens 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: JESSE R LING Licensee: Jesse R Ling Signature LIC.NO.: 15646 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 1200,WEST CHATHAM MA 026691200 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 , ...,ture Telephone No. PERMIT FEE: $80.00 Commonwealth of Massachusetts Official Use Only Permit No. { S qs J Department of Fire Services Occupancy and Fee Checked - - V BOARD OF FIRE PREVENTION REGULATIONS XRev.9/05] ( blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 1 All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5.2(7 CMR 12.00` (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: !-\P�-� ` ` , 2,0 Gq City or Town of: y A.iLV-tet-rtA 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) 4 7(G 't'hc Xk. c • Owner or Tenant ! Pe- 9 c'1 fs,`-t NC).is•1 Telephone No. Owner's Address S A N-4:2 Is this permit in conjunction with a building permit? Yes ❑ No pa (Check Appropriate Box) Purpose of Building o.1 (.- Utility Authorization No. X/A Existing Service , Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service �v A Amps / Volts Overhead❑ Undgrd El No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �q_p�14t is •S 2 Pit lc V 1 4.Q ( J© A Y 1.••c h<.l2 v c.-r AG,_ Cam,r-c b v c-t A`S c y OT4wir6 CoNfletion of the following table may be waived by the��r of Wires. 1Transformers of Recessed LuminairesNo.of Ceil.S No.of '►usp.(Paddle)Fans No.of Lummaire Outlets No.of Hot Tubs . Generators ' Move ❑ In- ❑ No.ot-Emergency No.of Luminaires��\ Swimming Pool g:rnd. Ern& Battery Units No.Of Receptacle Outlets `' o.,of Oil Burners No.of Zones ' �, C 10— o.of Detection and No.df Switches No.of GsBui era Initiating Devices Y.:: - ,No.of Ranges No.of Air Cond. T; , No.of Alerting Devices e ;'�Y`Y Heat Pump N ,, . Tons I ' No.of Self-Contained \ . No.of Waste Disposers Totals: *! «.on/o Muni Devices " J No.of Dishwashers Sp Heating KW ' onnec on 0 Other l 4, s .-, i .* cmef Dryers Heating Appliances KW N�Secnro.ty of cgs alent _. __ _ No.of Water No.o)' No.o Data Wiring: Heaters Signs Ballasts No.of Deices or Equivalent Telecommunications Wiring: No.Hydro,.. * •_e Bathtubs No.of Motors 'total HP No.of Devices or Equivalent O - :t R l Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: 4 l Oo (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:) I cat fy,under the pains and penalties of perjuly,that the informationon this application is true and complete. FIRM NAME: I,iii-6 kmec-'"t RO - Net-u.A3-u.CA- 1 LIC.NO. (S64b Licensee: . •1:7 • - 4'6 Signature LIC.NO.:E 3a3fi (If applicable enter"exempt"in the licepse manber line.) Bus.TeL No.•S08- _�33 Address: ,0X 11.00 v•-1 ;`A R'CkAA?" '`C A , Alt.Tel.No.: ..i *Security System Contractor License required for this work;if app le,enter the license number here: 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 ❑owner's agent Owner/Agent PERMIT FEE:$ O �� Signature Telephone No.