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HomeMy WebLinkAboutBLDE-22-004385 UNIT 5 or Commonwealth of Official Use Only � ; Massachusetts Permit No. BLDE-22-004385 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:2/8/2022 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) 845 ROUTE 28 Owner or Tenant JANFRA RLTY LLC Telephone No. Owner's Address 87 TONELA LN, BARNSTABLE, MA 02630 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: Replacement emergency light 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- o 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 Initiatine 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/Alerting 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 Ballasts Data Wiring: Heaters Signs 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: LAWRENCE R BROWN Licensee: Lawrence R Brown Signature LIC.NO.: 30708 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 LIMERICK CT, CENTERVILLE MA 026322713 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:$80.00 (->17i RECEI ED r " .._.._ - �/ M f� Official Use O ly � 1_,Ii I 6 o�iim� wealth o lire Permit No.1-AL1 3 ,,, 1 FEB 07 202apa isnatrl o��ira SerVlCaJ -f e; REVENTION REGULATIONS 41 Occupancy and Fee Checked *- BU I L. i�. QR� (Rev. 1/071 (leave blank) APPLICATION FOB PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: FE8 7 2022_. City or Town of:$/ 4fT 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) /� �� Owner or Tenant z�u/` u 7 i4 SiS _ Telephone No. `/' r/8 6o 3 o Q oo Owner's Address Yil5 © '` U'v, r `�_ /2`�C//o's /-'AJ2s Is this permit in conjunction with a building permit? Yes 0 No (Check Appropriate Box) Purpose of Building ,`' f/l4 Cin r,�r Utility Authorization No. Existing Service 10 0 Amps IL l /4410 Volts Overhead Undgrd 0 No.of Meters / New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters pt) Number of Feeders and Ampacity — / ���� 1 �v Location and Nature of Proposed Electrical Work: �'CeP! j E� / 4/� ,</G1/2/.T Completion of the following table may be waived by the Inspector of Wires. No.oTotal No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans KVA Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- o No.of Emergency Lighting ted• ate• 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 Nunlbcr_ __TQnS._ __ W__ No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other Connection No.of Dryers Heating Appliances KW Security Systems:* Noti of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW 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: ( Z- 5 (When required by municipal policy.) Work to Start: 2--5 —1-2-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 I& BOND 0 OTHER 0 (Specify:) I certify,under the pa' nan�d enalties of perjury, Oat the information on this applrpation is true and complete. -- FIRM NAME: L/C/<y , 0 .L/eC%�7,C'/C//5'n� LIC.NO.: 3.07014-- Licensee: d 7014 Licensee: " /cG r � Signature Sae 444''� . LIC.NO.: (If applicable,enter"exempt"in the license number line.) /, Bus.Tel.No: Address: `3 O . ,rnER/C/ C% Ce/f%Z�c 1/V/A' /VV/4 Alt.Tel.No.:J d /=�i *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 nor 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $