No preview available
HomeMy WebLinkAboutBLDE-21-000345 or tl, Commonwealth of Official Use Only ' ft-. 1 Massachusetts Permit No. BLDE-21-000345 . -x-_7BOARD 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:7/23/2020 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) 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 S �� Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appro!p , Purpose of Building Utility Authorization No. • CI Existing Service Amps Volts Overhead 0 Undgrd ❑ f t� t ft AA New Service Amps Volts Overhead 0 Undgrd 0 o. ' i tp1.iauhria► Number of Feeders and Ampacity '� e ` Location and Nature of Proposed Electrical Work: Upgrade lighting. Completion of the following table may be waived by the Inspec o •go res. 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/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 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: (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: Paul M Morris Licensee: Paul M Morris Signature LIC.NO.: 17520 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 213,1 COUNTRY WAY,SAGAMORE MA 025610213 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:$80.00 Commonwealth of Massachusetts Official Use Only r/ �._' ./ ` ti Permit No. � 3 `t s Department of Fire Services Occupancy and Fee Checked --`- M BOARD OF FIRE PREVENTION REGULATIONS [Rev..9/05] ,.� - (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code iv tiliiii7li.0MR 00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: q C - City or Town of: . \ To the Inspe•• • of`Wires: By this application the undersign �{L4 f A.f^gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) i I cap Pit lot; �'f-ieja ,r Owner or Tenant I k€.a _T .. r- K� L Telep, : ----0 Q ?�C'l , Owner's Address `Jv%k.A.i Arm 5 p A —c o - Is this permit in conjunction with a building permit? Yes El No ❑ (Ch= • A. .ro. : -, 'by I� Ems. Purpose of Building Utility Authorization , o. i Existing Service Amps / Volts Overhead 0 Undgrd I '.o.o e?s LI, @V7 Zi / New Service Amps I Volts Overhead Undgrd ■ --No,. Y , V r- Number of Feeders and Ampacity ��\—t r Location and Nature of Proposed Electrical Work: R q I,1 :. Q,f,,,e r .644;_e) ,Q„ti•1- Li Q' Completion of the following table may be waived by the actor of Wires. No.of : Total No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.In-Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ gmd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Initiatinng Detection and Devices • No.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 No.of Dishwashers Space/Area Heating KW Local❑ Conn tion 0 Other No.of Dryers Heating Appliances KW SecNa f Devices or Equivalent No.of WaterKW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or- No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications ._. y No.of�evtces or-�quiv 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: I"S Inspections-icbe requested in accordance with MEC Rule 10,and upon completion. INSURANCE COV GE: 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 ❑ (Specify:) I certify, under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME:q f"4 4A Q.,c4-y .1,-)NC-- LIC.NO.: Licensee:'?prt:.t.A nil p£4.4 S Signature, ./f:;‘---'.cd�%-‘,e_( LIC.NO.:/inn 141" (If applicable,enter"exempt"in the license number line.) ` Bus.Tel.No.s�9 176 16 94 1 Address: D 6 dy. �-i 3S A-t\N-tde M k- a ZS I Alt.Tel.No.: / *Security System Contractor License uired for this work;if applicable,enter the license number here: 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:$ iS. OU Signature Telephone No. ? rY► rv,ml u G •2 C.A t.C.r-,,ALT r