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Home My WebLink AboutBlde-22-004097 ,\\1 \ Commonwealth of Official Use Only E Massachusetts Permit No. BLDE-22-004097 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:1/25/2022 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) 1196&1198 ROUTE 28 Owner or Tenant HEARTH'N KETTLE PROP LTD PTR Telephone No. Owner's Address C/O H&K MANAGEMENT, 141 FALMOUTH RD, HYANNIS, MA 02601 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: Wire replacement water heatellillir 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. Batten,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 Initiatine Devices No.of Ranges No.of Air Cond. TTotal No.of Alerting Devices n 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 1 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 Eauivalent 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 ofperjury,that the information on this application is true and complete. FIRM NAME: Lance A Macenemey Licensee: Lance A Macenemey 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:$80.00 Olt( e 1 / 21/ vet }. _ (..ommonwaactli o�//laeeac�ua :It ;f c'''� of ci Use onl s �CJsparnt o �`rrs J'ervissa Permit No. uZ,.� ' ,',�,;.4'M BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked APPLICATION FOR PERMIT TOP Rev. 1/o7j leave blank ��'�"" All work to be performed in PERFORM ELECTRICAL WORK co FORMA Massachusetts Electrical Code{MEC},527 CM 12.00 v (PLEASE PRINT IN INK OR TYPE ALL INFpRM4TIQIV) Date: City or Town of By this application the undersigned ��''^ Inspect � �gives notice ofhis or her in To the or of Wires: Location(Street&Number) tesrtion to orm the electrical work described below. Owner or Tenant c Z- U r ft Owner's Address 1 e co L Telephone No. 4264 d Is this permit in conjunction with a building pets Purpose of Building Yes ❑ Na 0 (Check Appropriate Bog) J Eglsttng Service Amps / Utility Authorization No. Q _._.. _Volts Overhead❑ Undgrd N rrfc �._ Amps / �' ❑ No.of Meters O Number of Feeders and Ampaci Volts Overhead❑ Undgrd❑ No.of Meters Location and Nature of proposed Electrical Work: er h er lb No.of Recessed I, Com,letion o the ollowin: table m k Luminaires No.of Cdl.-Sus . be waived, the! , trot o Wires. No.of Lumhssdre Outlets p �' e)Fans `a•o KVA No.of Hot Tubs Transformers No.of Lumiinaire8 Generators KVA Swimming Pool , d. n- 'o.o No.of Receptacle Outlets rid' ❑ d. ❑ Batt Uni�tsency ; ,g No.of 01l Burners No.of Switches No.of Zones No.of Gas Burners ' No.of Ranges `o.o r et , I II an No.of Air Cond. ota IndianaDevices No.of Waste i Tons No.of Alerting Devices Totals: ... .... _.. ....OIIs ' ++ ti No.of Dishwashers °•o '' F onto a<< Space/Area Heating KW alDetec Co ertin i Devkes n No.of Dryers I�ocai uII , `o.o " Heating Appliances ❑ Connection ❑ Otlas• Heaters KW `o.a K�r a ems: No.of r aivalent S ,, O. Data Wiring: or No.Hydromaaaege Bathtubs Buts OTHER: No.of Motors No.of Devices or Total Hp lent e ,m„ , ,, µ , ins „ova: No.of Devices or ' i ; ent Estimated Value of Electrical Work: Attach Work to Start: (When tonal detail ifdesired or as rued the I INSURANCE CO Inspections to be �by municipal policy.) �' Inspector o}'Wj�., the licensee VERAGE: Unless waivedon bybested in accordance with MEC Rule 10 provides proof of liability the owner,no permit for the 10,cnd upon completion. ss undersigned provides certifies that coveragety insurance including"completed performance of electrical CHECK ONE: tesJthat such is in force, operation"coverage or its s work may issue unless I cent&HECK uner 0 BOND 0 OTHER exhibited proof of same to thesubstantial equivalent. The the Pamirs and penalties o 0 (Specify:) PeAn�t issuing office. FIRM NAME; r fpeyury that the fiifortrr ,n on this Licensee: , c► C )M application is true and comph a applicable ter"exempt" licnl LT Signature LIC.NO.: Address; N� rnlhe license nu r line. *Per M.G.L.c. 147,s.57-61 d T J ~- LIC.NO.: r ( Bus.Tel.No.• OWNER'S INSURANCE s. 7- WAIVER: work requires Department of public " „ �� -oa 3C required by law. ByI am aware Safety S License: AIL Tel.No.:�_�` that the Licensee Saf Owner/Agent my signature below,l hereby see does not have the liabilityins Lic.No. _ Signature Y waive this rent. I am the(check one urance cov erage no�Willy Telephone No. 1111 owner owner's a:ent. PERMIT FEE:$ 2'0 6