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HomeMy WebLinkAboutBLDE-22-000005 0 ..., Commonwealth of Official Use Only kin Massachusetts Permit No. BLDE-22-000005 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:7/1/2021 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) 115 ROUTE 28 Owner or Tenant Windrift Motel Telephone No. Owner's Address 115 ROUTE 28,WEST YARMOUTH, MA 02673 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: Repairs or corrections as required during inspection of 6-14-21. 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 041(‘-' KVA No.of Luminaires Swimming Pool Above 0 In- o No.of E nd. 11Li No.of Receptacle Outlets No.of Oil Burners FIRE ALA' 14 , - No.of Switches No.of Gas Burners No.of Detection a 1 8 8 Initiating Devices O 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 ❑ Oth• 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: Erik P Cousineau Licensee: Erik P Cousineau Signature LIC.NO.: 53394 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 140 OLEAN ST,WORCESTER MA 016024143 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 RECEIVED JUN 2 5 2021C° °" lth el/,lasaachaeatts Official Use Only `?N:'it,? c� n Permit No. Z2 � —b oo J,', A ,.---.__--._- _ ....___. s twtmsat°�,}irs Jarvu:se -. ,1hrr DING DEPARTMENT Occupancy y a I. BOARD F FI REVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK MI 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: 3j N e ao k-h 30,9 ) 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) I I, ?A- a 6 (u , M ).y)4 ,1 Owner or Tenant ,c5 ?PAE L Telephone No. 000 354- y/29 Owner's Address , (O s*,et-x- Gauer U-) , f rM 0v 1 1 I Is this permit in conjunction with a buil ng permit? Yes ❑ No LKJ (Check Appropriate Box) Purpose of Building .y'v\o L, Utility Authorization No. iExisting Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity E CLocation and Nature of Proposed Electrical Work: A i ea,f 2 f,)( vi Completion of thefollowingtable mi be waived by the Inspector of Wires. U. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total of Transformers KVA rc•„'..` No.of Luminaire Outlets No.of Hot Tubs Generators KVA ,t No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting irnd. grad. ❑ Battery Units �1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS ,No.of Zones No.of Switches No.of Gas Burners No.of Detection and ir No.of Ran es Total Initiating Devices g No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump l Number 1Tons I IZW No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ �� No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: p(� Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (9o©• (When required by municipal policy.) Work to Start: (()--a O•-(9 I 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 VI BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the Info, atlon on this application is true and complete. FIRM NAME: F,-,le, C c . /\e I (-k C (, L j LIC.NO.:S-3 391-1 - b Licensee: L f;V, Co o s;ei e M y Signature Z: /J— r LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: $U 3`9 LI S'(3)g 3 Address: i t-10 O rA� 5 t IN b C C Yv+ A' 6 160 Alt,Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my si ature b w,I hereby waive this requirement. I am the(check one) owner 0 owner's agent. Owner/Age Signature . ���� Telephone Noi71l-did-6374 PERMIT FEE:$ o�.._ q� _ TOWN OF YARMOUTH ELECTRIC ,0,,s+'•"41/1---- ? _ ;% GAS ;\, 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 +411 a Telephone (508) 398-2231, Ext. 261 —Fax (508) 398-0836 PLUMBING IMAA SEE E SIGNS BUILDING DEPARTMENT NOTICE OF VIOLATION Inspection Date: ra- 1 `-\ C 2► Inspection T e: P � P Yp LEakt - Property Address: I L' POLY Name: W ND-DR( IJ G1 3 Owner U_ Tenant ❑ D/B /A: Telephone: Mailing Address: W` City/Town: Weis-r Weis—ryAdepto v -( State:Lk4 Zip Code: 73 An inspection of the above captioned property was conducted by the undersigned, during which the following VIOLATIONS were obs rved: Rtvt 14Et-ef>.$ a.opeR eale-As `3g `r Ft,/ Ater 1i1pPeVr 4 Q Me-i1/ B ,‘ w t � ' --?6/1-1-20/ 'Ccc t (C,o2 TO) .O _ t 1' cC0-022 m (scoothi &4 `tei0 rb c -1 S eACK0&-lr (-)1\11 P:Q P/N-LS —7O 01: S'ecazel et:010th 7'" )1 N$ .J17/2, E 14 .7 3LYW�tt '1'b Rt-$4 ikE01 Srcuea OPT-11 -a- 13o 3( k Itati5X rb .54-614a7 You are hereby ordered to abate or correct said violations within days. Failure to do so may result in criminal/civil complaints being filed against you, which may be subject to fines as prescribed by pertinent laws and regulations, or may delay the issuance of your license. You are also required to contact the Building Department for a re-inspection by the time noted above. Signed: 6446DI /Ap io,e_. Inspector Title Copy Received By: -!r1''VV /Ct-✓U Original - Owner/Tenant Yellow Copy - Licensing Authority Pink Copy - Bldg. Dept. r . a- , r