HomeMy WebLinkAboutBLDE-22-005712 Commonwealth of Official Use Only
ZIP% Massachusetts Permit No. BLDE-22-005712
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:4/6/2022
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) 226 ROUTE 28
Owner or Tenant SIA DEVANG LLC Telephone No.
Owner's Address 226 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.°Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Bathroom fans,switches,receptacles, recesse i is in 13 rooms.
Completion of the folio ing table may be waiv by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No. f Total
Tra or r 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
Initiatine Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Ton
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 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 Siens 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: MICHAEL J PEARSON
Licensee: Michael J Pearson Signature LIC.NO.: 50954
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:75 CHAPMAN STREET,QUINCY MA 021702756 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: $230.00
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RE. Y. EIVED
[MAR30 202. `1 Commonwealth.of Madeachudolie Official Use Only
t
Permit No. -S712---
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11,1
2sparimsnd o/}ire ServicseBUILDINCUN1f ., Occupancy and Fee Checked
BY -71,,,,..11 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:
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) 22(v Ra U A-{
Owner or Tenant .5 VV p. (vii 5 14-Rcc' 41.-- , Telephone No.
Owner's Address'ZJ(c, Ren trTc., Z.Cil tt.r.S4- *Cr-r‘oU-I-In/ m47 6Z6 73
Is this permit in conjunction with a building permit? Yes ❑ No fa (Check Appropriate Box)
Purpose of Building(dre'vt**N CfC‘c�% V‘s, Utility Authorization No.
Existing Service Amps /lb Volts Overhead Er Undgrd E No.of Meters
New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters
Number of Feeders and Ampadty ..
Location and Nature trzorsed Electrical Work: repkce_ i 3 bc,4 m-aa1.,‘,..rs5 j repkvc. 13 5,re 3c ec
au 44 f KrP Ick 1 i t� 1/QStv1ptt in Sic I t 74 C'rCrsS
vi
+f Completion of the following table ntay be waived by the Inspector of Wires.
ill, No.of Recessed Luminaires No.of Ceil:Sasp.(Paddle)Fans No.of Total
`'r Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
,t` No.of Luminaires Swimming Pool Above o In- 1 o.of Emergency Lighting
grnd. grnd. 0 Battery Units
No.of Receptacle Outlets No.of Oil Burners
FIRE ALARMS INo.of Zones
No.of Switches No.of Gas Burners No.of Detection and
i t Initiating Devices
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number'Tons I l KW No.of Self-Contained
Totals: ”""'""'" f Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal
Connection ❑ oth er
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of No.of Devices or Equivalent
Heaters KW Data Wiring:
No.of
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 Worli ICS Oaf) (When required by municipal policy.)
Work to Start: 'i/ j7 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 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:
LIC.NO.:
Licensee: jam.% i C Kea r I J Signature LIC.NO.: 509 SL
(If applicable,enter"exempt"in the license number line.)
Address: $ G/NA Finan ,ST filo k Mc CZ I-76 Bus.Tel.No.;_
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lic.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance cove •: orma y
required by law. By my signature below,I hereby waive this requirement. I am the(check one ■ ownerAll owner's a:ent.
Owner/Agent
Signature Telephone No. PERMIT =
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