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HomeMy WebLinkAboutBLDE-22-002863 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-002863 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:11/17/2021 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) 52 LOCUST ST Owner or Tenant BLUE WATER LIMITED PARTNERSHIP Telephone No. Owner's Address 20 NORTH MAIN STREET, 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 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: Replacement boiler. 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 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices To 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 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 Ballasts Data Wiring: Heaters Signs 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: LANCE A MACENERNEY Licensee: Lance A Macenerney 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 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: $50.00 RF,CE VEO . A.. �onrnso eak i 0/#1aaaacliaaslfe Official Use Only }•,`' _•r NOV 17 202 cc.� cc�� Permit No. e2 22) .11 at 1) nt o�J`in Services r; It `. ,;( D N G U L rA T M E N T Occupancy and Fee Checked '' t,• Y biOARD-OEFIRE EVENTION REGULATIONS (Rev.1/07) (leave blank) 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 ilk-it-at --4 Cityor Town of: Inspectorof t�(M������ To the Wires: `) By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) j- ..) Lc)CC..�1/4.4c.4 S V Owner or Tenant e, yJekt e r L k A, 1 to Telephone No. �'' Owner's Address N(1;-0.--1 0-)0`,,,A S-i- j Qi Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Qt Purpose of Building Utility Authorization No. I Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters c New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity d Location and Nature of Proposed Electrical Work: Completion of the following.table may be waived by the Inspector of Wires. 'i. No.of Recessed Luminaires No.of Cell.-Snsp.(Paddle)Fans To.of otal Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators 'A 1. No.of Luminaires Swimming Poo1 Above ❑ In- ❑ No.of Emergency Lighting Arad. grad. Battery Units ry 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 tal No.of Ranges No.of Air Cond. Tons No.ofDevices Tone Alerting No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained __.�_._....__ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Se * curity ! :or Equivalent No.of Water , No.of No.ofWig. Heaters Signs Ballasts Data o.of Devices or uival nt No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications No.of Devices or Eq OTHER: Attach additional detail if desires 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 0 BOND 0 OTHER 0 (Specify:) I certify,under the rdns and penalties of perjury,that the infoiwtation on this application is true and complete FIRM NAME: Gk. I le rE lPc_ r 1 C CO CYO LIC.NO.: A (( I el Licensee: La kl o..t. nick-En C!1116.y Signature LIC.NO.: (If applicable.enter"exempt"in the license ber line.) ! Bus.Tel.No.:( L)S.) -11 S-66:6 Address: 1 d(A , 1) Te -k r w-"(0 WI c,c l 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/Agent Signature Telephone No. ( PERMIT FEE:$ 6,,Ck,