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HomeMy WebLinkAboutBLDE-22-001405 of Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-001405 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•9/13/2021 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) 2 WHITES PATH f. Owner or Tenant TWO AND TWELVE WHITES PATH LLC Telephone No. Owner's Address 23 B2 WHITES PATH, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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: Upgrade 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 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 No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine 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 Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent 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 cernfy,under the pains and penalties of perjuty,that the information on this application is true and complete. FIRM NAME: PAUL M MORRIS Licensee: Paul M Morris Signature LIC.NO.: 17520 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 213,1 COUNTRY WAY,SAGAMORE MA 025610213 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: $80.00 z E.1.1 Commonwealth Official Use Onl ? coladdacettd Y cZ t �ZZ 0 i Ct cc�� cc77 Permit No. .� ; C) 'al a 2epartment o� }ire Serviced f` 4 Occupancy and Fee Checked ; 4<'' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) C u 1! _, W I : PPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 15 m All work to be performed in accordance with the Massachusetts Electrical Code(Iy�E ),52 CMR 12.00 ' 'ASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 4�/ 1 z/ City or Town of: _— r^ To the Inspector o Wires: By this application the undersigned • es notice of his or her intentiontel � to perform the electrical work described below. Location(Street&Number) 1.. `A F$1' +v t -14 Owner or Tenant J t,/t. 1 0, MO.--v a&-F'��- Telephone No. 15 1 Owner's Address �j`� ,pr S Is this permit in conjunction with a building permit? 1 Yes ❑ No vg, (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters New Service Amps / Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (\t e ' - -- Q�e�) z_f e LI p,�"� I 1 aS -1 Completion of the following..table may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tf Trr ano KVAsformers KVA No.of Luminaire Outlets No.of Hot Tubs . Generators KVA No.of Luminaires Swimming Pool Above ❑ In- 0 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 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 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: AS Inspections'le requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE=E: 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 R' BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and enaltiiees of perjury,that the information on this application is true and complete. FIRM NAME:'P1fl PI € c,I4Qy L t -i'7tL LIC.NO.: Licensee: AtA..I /In 0 lie-f i S Signature LIC.NO.:/'75-LD i (If applicable enter"exempt"in th license number line.) /�a Bus.Tel.No.• , — Address:r0)4.ia- 1', 1 A r v'.o IL. t",l A— 0Z6 6I Alt.Tel.No.: 'IMP *Per M.G.L.c. 147,s.57-61,se un 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 El owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ 8-0 . ,..,Vl Y -p INN r eIec+1)L € e.Apc Cool. fe-n_