HomeMy WebLinkAboutBlde-21-006030 Commonwealth of Official Use Only
h _. Massachusetts Permit No. BLDE-21-006030
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:4/20/2021
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) 280 UNION ST
Owner or Tenant SAGE PAUL G Telephone No.
Owner's Address 14 MAIN ST, HYANNIS, MA 02601
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: Wiring of warehouse
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Sus Paddle Fans No.of Total
P'( ) 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 Gas Burners No.of Detection and
No.of Switches Initiating Devices
Totallo.of Ranges No.of Air Cond. Tons No.of Alerting Devices
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers Totals: Detection/Alerting Devices
Space/Area HeatingKW Local 0 Co Municipal No.of Dishwashers P Connection ❑ Other:
HeatingAppliances KW Security Systems:*
No.of Dryers PP No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts 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. CO _72,(0 , 014
CHECK ONE:INSURANCE 0 BOND 0 OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjwy,that the information on this application is true and complete.
FIRM NAME: Abraham D Smith
Licensee: Abraham D Smith Signature LIC.NO.: 21187
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:53 MAIN ST, PLYMOUTH MA 023603328 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) ❑ owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $300.00
t\- a ttin b.(
ac 5 1 (-7.t Cee.
11 4) oil``
Com1awnw.at L o/rne,Aseehosatu Official Use Only
i !raparurrtl pl� '!".Jawiure Permit No.
t'"", Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev.I/071 (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: 02/23/2021
City or Town of: Yarmouth MA 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) 280 union st
Owner or Tenant Forrest keepers I Paul se Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑x No ❑ (Check Appropriate Boa)
Purpose of Building Existing Utility Authorization No. NA
Existing Service 200 Amps
120 / 208 Volts Overhead❑ Undgrd 0 No.of Meters 1
New mice Amps I Volts Overhead❑ Undgrd❑ No.of Meters
Number of Feeders and Ampadty 3 @ 200 amps
ILocation and Nature of Proposed Electrical Work: Existing warehouse structure,power and lighting for general use.
t This is to verify that all work that was done has been brought un to the latest codes and standards.
Completion of the following table may be waived by the ltor of Wires.
t No
No.of Recessed Laminaire No-of Cell-Snap.(Paddle)Fans Tra onsformers ICVA
�,. KVA
No.of Luminai re Outlets No.of Hot Tabs Generators
+ lvo.of i ni en
Litibuni
- No.of Luminaires Swimming Pool e ❑ Id, ❑ Batter!"`Uni i C'
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners Na ofDetection and
�. initiating Devices
ii4 No.of Ranges No.of Air Cond. Toons No.of Alerting Devices
No.of Waste Disposers Heat Pump Ifamberb Tana_ KW -No.of Self-Contained
Totals:_ _ �__ Detection/Al r�I?evie s
No.of Dishwashers Spate/Area Heating KW Local❑ connection 0 Other
No.of Dryers Heating Appliances ICW NrilY o of �sr Equivalent
No.of Water KW No.of No.of Data Wiring
Heaters Signs Ballasts No.of Devices or ulvalent
No.H Bathtubs No.of Motors Total HP Tel No of Devi e '` ,
ydromasaage No.of Derma or �-; : '.nt
OTHER:
Attach additional detail tf desired or as required by the inspector of Wires.
Estimated Value of Electrical Work: 500.00 (When required by municipal policy.)
Work to Start: 2/23/2021 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 ❑ OTHER 0 (Specify:)
I certify,under the pains and penakks of perjury.that the information on this application is true and completu
FIRM NAME: LIC.NO.:
Licensee: Abraham D Smith Signature Abraham Smith M LIC.NO.: 21187-A
(If applicable,enter"exempt"in the license number line.) - Bus.Tel.No.:
Address: 53 main St Plymouth ma Abraham smrc „..
n ,..a Alt.Tel.No.:` 508-726-2504
'Per M.G.L.c. 147,s.57-6I,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 PERMIT FEE:a
Signature Telephone No.