HomeMy WebLinkAboutBLDE-21-007167 #1198 Commonwealth of Official Use�E Only
.�, Massachusetts Permit No. BLDE-21-007167
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:6/10/2021
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) 1196&1198 ROUTE 28
Owner or Tenant HEARTH 'N KETTLE PROP LTD PTR Telephone No.
Owner's Address CIO H&K MANAGEMENT, 141 FALMOUTH RD, HYANNIS, MA 02601
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
_.d
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 0KVA
No.of Luminaire Outlets No.of Hot Tubs Generat S".-�KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of i F4)grnd. grnd. Batte %
No.of Receptacle Outlets No.of Oil Burners FIRE ALA 0
4 ,
No.of Switches No.of Gas Burners No.of Detection a d
Initiating Devices 0 f.,:
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 Q
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 Data Wiring:
Heaters Siens 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
\ , ` Co' of Mcssackudets Official
1Use Only
. Permit No. C'� �—t 7((p 7
.
NI , e inertf o� ewiced
Occupancy and Fee Checked
til,.: BOARD OF FIRE PREVENTION REGULATIONS [Rev.i/07] (leave blank)
p APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),127 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATIO Date: 6I I
City or Town of: \•/f(i.-(moo�-N 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 Si Number) 11 9 $ /In A-3 /.l s-i-- C Q61,,r to ZA
Owner or Tenant -1-6w.. -r - (v. e S_o Telephone No. ip gp7 +( 0 ','
W
Owner's Address i I A- 73%Ct_A( ()✓1 l i' t.T I I 1 t•
Is this permit in conjunction with a building permit? Yes ❑ No IU (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps • / Volts Overhead 0 Un
dgrd❑ No.of Meters
tiatfraia Amps / Volts Overhead 0 Undgrd 0 No.of Meters
.-Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: ' Q / , i_A ' f . t -.
, letioa,, the oll, ',: table m, .be waived, the I ,: or, Wirer.
No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans o.o o
.
Transformers
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No..of LuminairesSuring Pool ❑ la- PiEmnitsergency Lighttng
No.of Receptacle Outlets tend. ❑ o.of U
No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners.. No.of Detection and
No.of RangesInitiating Devices
No.of Air Cond. Total ns No.of Alerting Devices
No.of Waste Disposers . t 'umAim p m er oT '�"ns - lo.o e T. ontaine
Totals: r erection/Alertin, Devices
No.of Dishwashers Space/Area Heating KW Local 0 u pa
No.of Dryers Heating Appliances Connection Other
No.of Water ICV No.o=
*or of -No of or Equivalent
Heaters KW Data .
No.Hydromassage BathtubsSigns Ballasts No.of Devices or -,nivalent
No.of Motors Total HP Telecommunications 4 ,,,••
OTHER: No of Devices or E4 t t
'Attach additionl detail brdesirrd.oras
Estimated Value of Electrical-Work: Te4ud by rhe Inspector of Wars
Work to Start: ��required by municipal policy.)
oma- 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"coverageor its substantial
undersigned-certifies that such coverage is in force,and has exhibited equivalent. The
CHECK ONE: INSURANCE BONDproof of same to the permit issuing office.
I cert under 0 OTIR 0 (Specify:) •,.
�anlas and penalties ofperfury,that the information on this application is true and complete.
FIRM NAME: l tlnriFA ea- 1 C.- .g-tw.. . -
Licensee:�/�.cf ° LIC.NO.:
d.r' -)'4 Signature ,,, 6 LIC.NO.: /15,0 A—
ar appticabl nter"exem t"in the license number line.) 3b$�l I-917
�,y
Address: Or Ii_ ./p3 S -! ,f 1 i ly 2 Bus.Tel.No.:
*Per M.G.L.c. 147,s.57-61,secure work — Alt.Tel.No:
ty requires Department of Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this
Owner/Agent - I am the(check one)❑owner ❑owner's agent
Signature Telephone No. I PERMIT FEE.$ o 0 . CA) I
IF ChLtize.cam!. iii..F''