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HomeMy WebLinkAboutBLDE-22-001730 #250 04* Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-001730 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:9/27/2021 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) 237 NORTH MAIN ST Owner or Tenant DAVENPORT DEWITT TR Telephone No. Owner's Address DAVENPORT REALTY TRUST, 20 NORTH 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 k [a Completion of the following t,.le., - r nspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of �/Total Trans ••, rs �o) 46 VA No.of Luminaire Outlets No.of Hot Tubs GeneratoA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergen O grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.o No.of Switches No.of Gas Burners No.of Detection and D Initiatine 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 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 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 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 Commonwea[pt o/V104,144 1444116 �Official Use Only q 2 �' ;: = 'r cc�� cc77Permit No. 1:. 7/Z 1 i J 0 ern; 2).partinent oIra�orvicae 1 i---,--'4* Y" Occupancy and Fee Checked 1/41/4. 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: q L31. 0 City or Town of: \10(nt\O tAK 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&Num� 1 ► 1C Number) ?3 7 K, i ' S.+, ' n 1 + a50 Owner or Tenant—1- i r,4O6d P 'Gkte, Telephone No. AJ el Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) -75 Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters vNew Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters e ' Number of Feeders and Ampadty ® Location and Nature of Proposed Electrical Work: g e_h n A.4-'t O n �S ' Q t Yl c�- V Completion of thefollowingtable may be waived by the Inspector of Wires. LID No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Tof 'Dotal Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ Ba of emergency Lighting grad. grad. Battery Units No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners "No.Initiatinnggon Deteand Devices Ili 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/Alertint )evices No.of Dishwashers Space/Area Heating KW Local 0 MonneunidMp ion ❑ oto C No.of Dryers Heating Appliances KW Securitys:* Na of Die s or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or ' 'uivalent No.Hydromassage Bathtubs No.of Motors Total HP Teleco of Deunivicesces o of No. Deorns W Egaiv nt OTHER: Attach additional detail rf desired,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 0 BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of palmy,that/no--the information on this application is true and complete. FIRM NAME: Rd ter p 11.L r%C w MQ(l' LIC.NO.: f A I 1�'1 Licensee: 14(\e-e... wad, En erne./ Signature �� LIC.NO.: (If applicable,enter"exempt"in the lice a numbe line.) Bus.Tel.No.: SOS- `77c- OO 30 Address: Ialplq M c d Ter...V\ Dr Vi. tl(t'1'1Qu+k Alt.Tel.No.: *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 not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)p owner 0 owner's agent. Owner/Agent Signature Telephone No. (PERMIT FEE:$ $0.00