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HomeMy WebLinkAboutBLDE-22-001697 Commonwealth of Official Use Only it-`r1', i Massachusetts Permit No. BLDE-22-001697 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:9/24/2021 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) 582 ROUTE 28 Owner or Tenant Chelsea's Swimwear Telephone No. Owner's Address CENTERVILLE 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: Upgrade lighting. 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 O / /KVA No.of Luminaire Outlets No.of Hot Tubs Generators fr(a / A No.of Luminaires Swimming Pool `4rnde ❑ Irnd. ❑ No.of E, , i y�= o/// g g Battery i No.of Receptacle Outlets No.of Oil Burners FIRE ALA• o No.of Switches No.of Gas Burners No.of Detection an• 8 O O Initiatine Devices l 4P No.of Ranges No.of Air Cond. ToTonI No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices D 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 Eauivalent 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: 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 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 Commonwealth o////addachu setto Official Use Only ' c� c7 Permit No. 62-z_-(bq 7 t ;ri 2)epartment o/J�ire Servica6 _![:17 -51 Occupancy and Fee Checked ' 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(ME ),527 CMR (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 14 8—D II ;.q City or Town of: it}-LPIVOLL To the Inspec or of Wires: _- By this application the undersign gives notice of his or her i i tention to pe.orm the electrical work described below. Location(Street& 'umber) 8 3_-- f V I„ A L 7' Owner or Tenant i k.2 ; ,' ,l _ .A.-.A. ` G( Telephone No. 0 3 7 Owner's Address A'jt"}'y, 1-. i Q--S dkel.cp, Is this permit in conjunction with a building permit? Yes • No E (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd El No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (Zee r� 9,L,,_) ,i .�;LA ,'1, 11' aki'S 1 Completion of the following table may be ►wa'ived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tf Trr anoKVAsformers 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 g 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 0 Municipal o 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: r • Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: .0 c (When required by municipal policy.) Work to Start: Inspections tela: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 Ey BOND ❑ OTHER 0 (Specify:) I certify,under the pains and enalties of perjury,that the information on this application is true'and complete. FIRM NAME:'pm ert tia.c. 7- L t�I,L . , LIC.NO.: LicenseeT i 1 ( o rr i S Signature LIC.NO.:/75. • (If applicable enter"exempt"in th license number line.) ^, Bus.Tel.No.• Address:)O�C.2.,i-5 A.tVt 6(1_1 '"l.Pr Q7_5(W I Alt.Tel.No.: "l P *Per M.G.L.c. 147,s.57-61,s dun 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ Sk:bp -pnr,meIec,-/-()LeeA-pc Coot. neT`