HomeMy WebLinkAboutBlde-21-004664 0%0 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-21-004664
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:2/17/2021
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) 327 SOUTH SHORE DR
Owner or Tenant RIVIERA BEACH LTD PARTNERSHIP Telephone No.
Owner's Address 20 N MAIN ST, SOUTH YARMOUTH, MA 02664-3150
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: Renovations, Room#'s: 134, 135, 136, 137, 138, 143, 145, 147, &241.
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
Tons
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 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: 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
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: $180.00
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Commonwealth o/Maddachadettd Official Use Only
1-4N cc�� C� Permit No. - -�`' '64
'—"" 2eeartment o/3ire Serviced
ir -I 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(MEC),527 CMR 12,00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Ph/0/
City or Town of: 1.6116u,-t; __ 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) 8 gq S --h bilo re r Ma Parcel# 1/8'
Owner or Tenant Qk i ei( P40h Li-d PQ -he f 5k i P Telephone No.
Owner's Address PC) NEWt-h f C't&t t\ +.
Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No..
Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
Rpfr6 New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters
I ,f Number of Feeders and Ampacity
`( Location and Nature of Proposed Electrical Work: goo to remodel mc,t;n`i 0 k,d-Ids + aJdi n9 a Ee 4,av„(4-
k35 rce-e-tc>tale5 bed sicte, -Va.ble ba h�ocm a-TV loe:c ions
Completion of the following table may be waived by the Inspector of Wires.
`3 fo No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.Transformersof Total
KVA
1 37 No.of Luminaire Outlets No.of Hot Tubs Generators KVA
N No.of Luminaires SwimmingAbove In- No.of Emergency Lighting
Pool grnd. ❑ grnd. ❑ Battery Units .
`i 3 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
1jNo.of Switches No.of Gas Burners No.of Detection and
k'tInitiating Devices. _
IT I No.of Ranges No.of Air Cond. Ton No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: m'm'"""""'' Detection/Alerting Devices
I No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other
i Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices_or Equivalent
No.of KWater , No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or E_uivalent
No.Hydromassage Bathtubs No.of Motors Total HP Teieeo of Deviunces or Equivalent
OTHER:
Attach additional detail if desire4 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 ❑ BOND 0 OTHER ❑ (Specify:)
I certify,ander the pains and penalties of perjury,that the information on this application is true and complete
FIRM NAME: I ec--c< MOxt sI —... LIC.NO.: A I i i y q
Licensee: 1_Q nu. rY1° G n t ve ' uignatur-e - C.NO.:
(If applicable,enter"exempt"in the license number dine. Bus.TeL No.:�(O1-715-00 3!)
Address: l b rifV,(1 "Teak Il( Wa r ma k.</ Alt.TeL No.:
*Per M.G.L.c. 147,s.57-61,security work requires epartment.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 0 owner's agent
Owner/Agent PERMIT FEE:.$ I Signature Telephone No.
*IMPORTANT:A separate permit is required for the installation of smoke detectors.Fire Alarm inspections are Performed by the FD having iurisdinfinn