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Home My WebLink AboutBlde-21-006824 , x o• Commonwealth of Official Use Only fill ti i NI Massachusetts Permit No. BLDE-21-006824 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:5/24/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 817 ROUTE 28 Owner or Tenant KIM HOLDINGS LLC Telephone No. Owner's Address DBA CAPT GLADCLIFF,817 ROUTE 28 ATTN:OFFICE, 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: Emergency repairs to 0/H service. 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 Initiatinc 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 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 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: WILLIAM C FLIGG Licensee: William C Fligg Signature LIC.NO.: 12584 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:55 FREEMAN RD,YARMOUTH PORT MA 026752304 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:$100.00 4/ham �� (fif fi( kr pril mine_ Cb T t-d'Z qz(/2+ Grp CommonweaUh 0/Mamadwatt.4 Official Use Only �Q�/ Q r "` �'_si c� Permit No. C.,V—lP Z��4 —_._ 2spartment of 3ire_ervicee i-5" Occupancy and Fee Checked BOARD OF FIRE PREVENTION 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 EC ,527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: '20 2 J City or Town of: Yco-1M0( To the In pec or of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) '17 VL so Z S, YA.e.tm_ovUA 1N1. OZCakif Owner or Tenant IL T M jci,fr,Ss U( 1bE A- Co�Q�-, G 16 cc h4 - Telephone No. Owner's Address J Is this permit in conjunction with a building`permit? Yes ❑ No Fla"--- (Check Appropriate Box) Purpose of Building 1�7 (-1.3Al�,y�i_ btVir!1 v,.,o Utility Authorization No. Existing Service f6o Amps / /Z�/b V s Overhead Er Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: t, C \ cp i i-- � � ,CU_ a ,(ci €_ -(-(C "r 1 Cq I SAA.-viCSL , Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf TVA Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of No.of Switches No.of Gas Burners No. Initiatinnggon Dete and In Devices No.of Ranges No.of Air Cond. Total g Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons K W No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ Other p Connection NN No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent pNo.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent It No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Whin Y g No.of Devices or Equivalent 6 OTHER: r\-- Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Elec 'cal Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE O RAGE: 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 covers a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE C9 BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete: FIRM NAME: Cry 4'1l iM CI, Ci eCr,c 1ait-, U,�/ LIC.NO.: ( q Licensee: U\JJJ,wVl (' ili Signature 4. / LIC.NO.: (If applicable,enter "exempt"in the l@se number line.) Bus.Tel.No.:72079 y7y y Address: 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: $