HomeMy WebLinkAboutBLDE-21-004917 ttsiCommonwealth of Official Use Only
fi-. ,t Massachusetts Permit No. BLDE-21-004917
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:3/2/2021
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) 1300 ROUTE 28
Owner or Tenant IRAN FAMILY LLC Telephone No.
Owner's Address 156 SEA ST,QUINCY, MA 02169
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 KVA
No.of Luminaire Outlets No.of Hot Tubs Generators Oie W A
No.of Luminaires Swimming Pool Above 0 In- 0
No.of Emer a ig •
grnd. grnd. Battery U07.-2 g..�
No.of Receptacle Outlets No.of Oil Burners FIRE ALA '`.
No.of Switches No.of Gas Burners No.of Detection • 1
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices O O
Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained10
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Ot
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
Cosmorama:A o`I asaacIuddffd Official Use Only
s Permit No.L-24 6.1 -' ( (
rI .1lelaarranE o��sre ervdces
% BOARD OF FIRE PREVENTION REGULATIONS u and Fee Checked
7< •,:,,.,' [Rev. l/07]
(leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00
(PLEASE PRINT IN INK OR .E ALL INFORMATION) Date: 2i -Z- �6z
City or Town of: 1� To the Inspe or ores:
By this application the undersigned ves notice if his or her ,o ,tion to perform the electrical work described below.
- �`
Location(Street&Num, . ) i 1.
Owner or Tenant ,a fie. :,0` ,e et Telephone No.
Owner's Address %0 �,1 Q,, .Cl •
Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps . / Volts Overhead 0 Undgrd❑ 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: i .e f�Ia� e-9 y (fii. �
•
Completion ofthe following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 1No.of Ceil.-Susp.(Paddle)Fans No.of. Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA •
No.of Luminaires Swimmin Pool Above In- Ivo.of Emergency Lighting
Swimming fid. grad. Batte Units
/FIRE No.of Receptacle Outlets No.of Oil Burners 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
No.of Waste Disposers 'Heatoummpp I Number I Tons I KW- No.of SeltContained
I Detection/AlertinkDevices
No.of Dishwashers Space/Area HeatingKWMunicipal '—
Local❑ Connection 0 Other
No.of Dryers Heating Appliances KW Security ,ys, a
No.ovices
No.of Water KW No.of -No.of Data Wif:ng or Equivalent
HeatersSigns Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wirin
No.of Devices or Equivalent
OTHER:
�` Attach additional detail If desired,or as required by the Inspector of Wires
Estimated Value of Electrical Work: 1 (When required by municipal policy.)
Work to Start PK.Ptep Inspections i 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"conipleted 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 j' BOND ❑ OTHER 0 (Specify:) .
I certi13'y undue' and penalties of fury, the information on this application is tree and complete.
FIRM NAME; ferias V ea- L t,,,PK- . LIC.NO.:
Licensee:--PA10./ 1 i.. O dr'p %4 Signature ,:,ib , LIC.NO.: /15 A-
ar appiicable,,pnnter"exempt"in the licg a number line.) Bus.Tel.No.:
•
Address: .1 S'/¢{� A-114Ale t Ai/'t of 2 $/ Mt.Tel.No.:
•
*Per MAIL.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's a.Rint
Owner/Agent
Signature Telephone No. I PERMIT FEE:$ I D.
p14 A.iid0-e-Ys:.L 1e CL Com. /um-