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HomeMy WebLinkAboutBLDE-22-006751 VANITY Official Use Only CCommonwealth of lie* Massachusetts Permit No. BLDE-22-006751 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.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 ;ASE PRINT IN INK OR TYPE ALL INFORMATION) Date:5/23/2022 To the Inspector of Wires: City or Town of: YARMOUTH his application the undersigned gives notice of his or her intention to perform the electrical work described below. ation(Street&Number) 192 SOUTH SHORE DR UNIT 1 ner or Tenant Horizon Engagement, LLC Telephone No. ner's Address his permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) pose of Building Utility Authorization No. sting Service Amps Volts Overhead 0 Undgrd 0 No.of Meters v Service Amps Volts Overhead 0 Undgrd 0 No.of Meters tuber of Feeders and Ampacity :ation and Nature of Proposed Electrical Work: Re-Install previously unlisted lighting fixtures for vanity's in 49 rooms. Completion of the following table may be waived by the Inspector of Wires. No.of Total ►.of Recessed Luminaires No.ofCeil:Susp.(Paddle)Fans Transformers KVA ).of Luminaire Outlets No.of Hot Tubs Generators KVA Above ❑ No.of Emergency Lighting D.of Luminaires 49 Swimming Pool grnd. ❑ In-grnd. Battery Units D.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Detection and o.of Switches No.of Gas Burners Initiatine Devices Total No.of Alerting Devices o.of Ranges No.of Air Cond. Tons Heat Pump I Number I Tons I KW No.of Self-Contained o.of Waste Disposers Totals: Detection/Alertine Devices Local ❑ Munici al o.of Dishwashers Space/Area Heating KW Conne cion 0 Other: Security Systems:* M.of Dryers Heating Appliances KW No.of Devices or Equivalent No.of No.of Ballasts Data Wiring: Le Water KW Siens No.of Devices or Equivalent [eaters Telecommunications Wiring: Jo.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent )THER: • _ Attach additional detail if desired,or as required by the Inspector of Wires. stimated Value of Electrical Work: (When required by municipal policy.) fork to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. VSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides roof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage in force,and has exhibited proof of same to the permit issuing office. ;HECK ONE:INSURANCE 0 BOND 0 OTHER ❑ (Specify:) certify,under the pains and penalties of perjury,that the information on this application is true and complete. rIRM NAME: MICHAEL S WALSH LIC.NO.: 51043 Signature Bus.Tel.No.: Licensee: Michael S Walsh Alt.Tel.No.: I applicable,enter"exempt"in the license number line.) A dp MARSTONS MLS MA 026481015 Address:36 BOSUNS WAY, "S"License: g law.But my *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety ❑ owner's agent. I am aware that the License does not have the liability insurance coverage normallyrequired y OWNER'S INSURANCE WAIVER: 0 owner 41tatuN below,I hereby waive this requirement.I am the(check one) PERMIT FEE: $345.11 U o Agent TelepboneNo OwnerlAg Signature 7 rl tw+.--- I. 31.s�� RECEIVED d A. 7'« MAY 2 0 202 °loaw.aL G/ laaaachuastfe Official Use Only , -v. >I o e/ c7 Permit No. El-2- --(o'(5 7 N1 s caTiifunf o`3. Stru• d 4 1i r': i DING U E NA R T M E N T Occupancy and Fee Checked P .,,._s,-` ,--.:. -REVENTION REGULATIONS [Rev. 1/07] (leave blank) 0 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 0.4K),527 CMR 12.00 J (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: j (f (LI— (...) City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her inte ion to perform the electrical work described below. Location(Street&Number) (gt 5 S[..ar(, \) r - Owner or Tenant H 0 r• 12on E.n c,SeJ _XAJV 1- t,,L'C_ Telephone No. Owner's Address in 5 3L. &. or . ,�, Is this permit in conjunction with a building permit? Yes ❑ No ET (Check Appropriate Box) J Purpose of Building to Utility Authorization No. ���YYYd... Existing Service 6u9 Amps No /It 5 Volts Overhead Er Undgrd❑ No.of Meters co New Service Amps / Volts Overhead Undgrd 3 ❑ g ❑ No.of Meters tA Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (i7/10,,...(k til \i"... .-.‘ L S K.P! Completion of thefollowingtable may be waived by the Inssector of Wires. vv No.of Total t! No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans es/ Transformers KVA 1:...t No.of Luminaire Outlets No.of Hot Tubs Generators KVA t No.of Luminaires bSwimming Above In- 'No.of Emergency Lighting ` ` Pool grad. 0 grnd. 0 Battery Units 4' No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones , ` No.of Switches No.of Gas Burners "No.of Detection and c. Initiating Devices 1 r No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons KW 'No.of Self-Contained Totals: `" " Detection/AlertingDev ces No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ other, Connection No.of Dryers Heating Appliances KW Security Sys tem Devis or Equivalent No.of WaterKW 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 ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 5 00 (When required by municipal policy.) Work to Start: $(t° ZZ. Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov'a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [. BOND 0 OTHER 0 (Specify:) I certify,under the painsa>;d penalties of perjury,that the Information on this application is true and complete., FIRM NAME: �l� v"I,"„_e�( 5 �,+4�1L, 7.6.. LIC.NO.: J/a tI Licensee: µL`.i.4 S c..S-- 5(1- Signature -7.4.____."A L ' /" LIC.NO.: 31 O q 3 'I f e t r"esempt"in theb .O° number 1kv Ca C I Bus.Tel.No.: Address: 11 \ Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ tntertek Total Quality.Assured. Horizon Engagement LLC SCOPE OF WORK Field Evaluation Report of various installed lighting fixtures REPORT NUMBER 105013179NYM-001 ISSUE DATE 20-April-2022 PAGES 9 "11141% DOCUMENT CONTROL NUMBER RT-R-AMER-Insp-3319 © 2017 INTERTEK Intertek NYM Lntertek Fairfield NJ 07004 Total Quality.Assured. Telephone: 973-461-1845 www.intertek.com FIELD EVALUATION REPORT Report No.: 105013179NYM-001 Date: 20-April-2022 Mr. Robert E Blood Ph: 2074239387 Horizon Engagement LLC 29 Main St Amesbury, MA 01913 email:rob@larkhotels.com Reference: Intertek Project Number G105013179 Subject: Intertek Field Evaluation Report of various lighting fixtures Dear Mr. Blood, This report provides the results of the field evaluation that was conducted on your above referenced equipment to the fequirements contained in the following standards: Luminaires[UL 1598:2021 Ed.5+R:18Jun2021] The evaluation was authorized by proposal number Qu-01252187-1, dated 03/15/2022. Our evaluation of the new and installed equipment took place on 4/19 and 4/20 at Parker Beach Lodge 192 S. Shore Drive,Yarmouth, MA 02664 The lighting fixtures have been investigated to the Standard indicated above as far as practical in the field and was found to be in essential compliance with those requirements. The equipment was labeled with our serialized Field Evaluation Label upon completion of our evaluation as noted in the details section of our report. If you have any questions, please feel free to contact us at your convenience. We are looking forward for future opportunities to work together. In Charge of Testing: Scott Peterson Sr. Staff Engineer- NYM Scott.peterspon@intertek.com This report is for the exclusive use of Intertek's Client and is provided pursuant to the agreement between lntertek and its Client. Intertek's responsibility and liability are limited to the terms and conditions of the agreement. Intertek assumes no liability to any party,other than to the Client in accordance with the agreement,for any loss,expense or damage occasioned by the use of this report. Only the Client is authorized to permit copying or distribution of this report and then only in its entirety. Any use of the Intertek name or one of its marks for the sale or advertisement of the tested material,product or service must first be approved in writing by Intertek.The observations and test results in this report are relevant only to the sample tested.This report by itself does not imply that the material,product,or service is or has ever been under an lntertek certification program. Version:02 May-2017 Page 2 of 9 GFT-OP-10b FIELD EVALUATION REPORT FOR HORIZON ENGAGEMENT LLC Report No.: 105013179NYM-001 Date: 20-April-2022 Rendered To: Horizon Engagement LLC 29 Main St Amesbury, MA 01913 Contact: Rob Blood Pho: 207423938 Email: rob@larkhotels.com Performed By: Intertek Testing Services NA, Inc. 41 Plymouth Street Fairfield NJ 070044 USA Tel: (973)461-1845 Products Covered: Various lighting fixtures Inspection Site: Parker Beach Lodge 192 S. Shore Drive Yarmouth, MA 02664 Results The equipment noted in this Report has been investigated and, as far as practical in the field, has been found to be essentially in compliance with the requirements of the following standards: Luminaires[UL 1598:2021 Ed.5+R:18Jun2021] Complete information and details of the investigation are on file at this office. The installation methods and final approvals at the installed site are the responsibility of the Local Inspection Authority Having Jurisdiction (AH1). Please note:this Report does not represent authorization for the use of the Intertek ETL Listing Mark. In Charge of Testing: Approved by: Scott Peterson Peter Sedor Sr. Staff Engineer Reviewer Intertek- NYM Intertek- Box Scott.peterson@intertek.com peter.sedor@intertek.com Version: 14-March-2017 Page 3 of 9 GFT-OP-10b FIELD EVALUATION REPORT FOR HORIZON ENGAGEMENT LLC Report No.: 105013179NYM-001 Date: 20-April-2022 INDEX SECTION NAMES PAGE 2 Scope 5 3 Product Evaluation Procedures 5 3.1 Standards 5 3.2 Visual Inspection 5 3.3 Product Type Testing 7 3.4 Resolution of Discrepancies 7 3.5 Technical Report 7 4 Product(s) Evaluated 7 4.1 Equipment Identification and Field Label Number(s) 7 4.2 Conditions of Use 8 4.3 Schematics and Photographs 8 Version: 14-March-2017 Page 4 of 9 GFT-OP-10b FIELD EVALUATION REPORT FOR HORIZON ENGAGEMENT LLC Report No.: 105013179NYM-001 Date: 20-April-2022 SCOPE This Final Field Evaluation Report provides the results of the evaluation of non-certified or other special equipment described in this report. The purpose of these inspections is to provide a review of the electrical constructions of the equipment and provide a degree of assurance that the constructions comply with the requirements of the appropriate standards. The evaluation is based upon a combination of the essential requirements in the identified product standard and the recommended practices for evaluations as covered in Chapters 5 and 6 of NFPA 791 Recommended Practices for Field Evaluations This evaluation is limited to the equipment itself and is not specifically intended to identify issues with the supply wiring other than the rated capacity and method of termination to the equipment. The installation methods and final acceptability at the installation site are the responsibility of the Authority Having Jurisdiction. PRODUCT EVALUATION PROCEDURES 3.1 Standards: The standards used in our evaluations are the applicable American National Standards Institute (ANSI) standard, National Fire Protection Association (NFPA) standard, other Approved product standards, or Approved State or local ordinances. 3.2 Visual Inspection:A visual inspection of the equipment was conducted, comparing product construction to requirements of the applicable standard.The evaluation included directly connected loads to the equipment identified in the report. Complete inspection records are on file at Intertek. Suitability for Use and Location:The equipment was found to be suitable for the «Typelocation» location.There were no adverse environmental conditions found that would impair the proper operation and use of the equipment.The equipment was suitably protected from physical damage. Condition of the equipment:The equipment was in satisfactory condition. No components were found to be damaged in a manner that impacted performance and operation. Metallic parts of the equipment had suitable corrosion protection. Nonmetallic parts were not likely to suffer deterioration or create a fire hazard. Access and Workspace clearances: Access was provided about all electrical equipment to permit ready and safe operation and maintenance of the equipment.The work space clearances for electrical enclosures likely to require examination, adjustment, servicing, or maintenance while energized were provided in compliance with the NEC®Section 110.26 and the applicable standard. Exposed Parts:Adequate spacings, creepages, and clearances were provided between live parts of opposite polarity and noncurrent-carrying metallic parts, or suitable barriers were provided. Where live parts were exposed suitable guards or barriers were provided. Separation: Electrical conductor insulations of different voltage systems were found to be either rated for the highest voltage or were separated by suitable barriers. Electrical wiring was separated from other utilities such as oil and water by suitable barriers. Version: 14-March-2017 Page 5 of 9 GFT-OP-10b • FIELD EVALUATION REPORT FOR HORIZON ENGAGEMENT LLC Report No.: 105013179NYM-001 Date: 20-April-2022 Grounding and Bonding:All required noncurrent-carrying metallic-I parts of the equipment have been determined to be suitably bonded to the supply equipment grounding conductor.The equipment grounding conductors and bonding jumpers were terminated properly. Equipment grounding conductors and bonding jumpers served no other function. Internal Overcurrent Protection:The type and ratings of the overcurrent protection provided within the equipment was suitable for the conductors and loads served. External Overcurrent Protection:The rating of the overcurrent protection from the source to the equipment was verified as stated below: Type of OCD Rating Circuit breaker 15A The determination of the amount of available fault current of the electrical supply delivery system to the equipment was not a part of this evaluation. Conductors: All equipment wiring was found to be certified for use, accepted by testing,or verified as acceptable. Conductors were used within the applicable voltage and temperature ratings. Conductor sizes were in accordance with the allowable ampacities given in the standards identified in this report. Wiring Methods:The equipment wiring methods were properly secured, supported, and routed away from physical damage.The wiring methods utilized in and one the equipment provided the required separation and protection from live parts as required by the standards noted in this report. Field Wiring Terminations:All field wiring terminals were identified and were suitable for the conductor type, stranding, and ampacity of conductors being terminated.Terminals suitable for more than one conductor were marked. Guarding of Equipment:The evaluated equipment identified in this report has been provided with suitable covers, enclosures, and guards as required by the standards used for the evaluation. Fastenings used for covers were in accordance with the standard. Markings: Where applicable the required Caution,Warning, and Danger markings were provided on the equipment. Complete nameplates were provided as required by the standard. General Engineering Practices:The equipment was constructed to meet the requirements of the standards identified in this report.The equipment was constructed in a workmanlike fashion. Other Comments: This equipment was evaluated for use at the installed site noted on the cover page of this report only. Any modifications or moving of the subject equipment requires a re-evaluation. Version: 14-March-2017 Page 6 of 9 GFT-OP-10b FIELD EVALUATION REPORT FOR HORIZON ENGAGEMENT LLC Report No.: 105013179NYM-001 Date: 20-April-2022 3.3 Product Type Testing:The electrical tests conducted on the equipment followed the standards identified in this report as closely as practicable, considering the limits of a non-laboratory setting and the need for the equipment to perform all required functions after the tests.The following non-destructive tests were conducted with satisfactory results.Test results are on file at the Intertek office. • Normal temperature • Grounding/bonding continuity verification 3.4 Resolution of Deficiencies: Any deficiencies identified on the subject equipment during the evaluation and testing process are noted in the table below. Methods of resolution are reviewed, agreed upon, and verified by Intertek before the ETL Label was applied. Deficient Approved',Resolution None N/A 3.5 Technical Report: Upon completion of the Field Evaluation and application of the Field Evaluation Label, this final technical report was prepared and issued to<co>, and to the local Authority Having Jurisdiction (AHJ)for the installed site. Version: 14-March-2017 Page 7 of 9 GFT-OP-10b FIELD EVALUATION REPORT FOR HORIZON ENGAGEMENT LLC Report No.: 105013179NYM-001 Date: 20-April-2022 PRODUCTS EVALUATED 4.1 Equipment Identification and Field Label Number: Field evaluation of various lighting fixtures. All units are rated 120V, 60Hz Room Lights Room Lights Room 101 Chandelier—506836 Room 201 Chandelier—506793 Wall Sconces (2) -506835,506834 Wall Sconces (2)—506792, 506791 Bathroom—506833 Bathroom—506790 Room 102 Chandelier—506840 Room 202 Chandelier—506789 Wall Sconces (2) -506839, 506838 Wall Sconces (2)—506788,506787 Bathroom—506837 Bathroom—506786 Room 103 Chandelier—506844 Room 203 Chandelier—506785 Wall Sconces (2)-506843, 506842 Wall Sconces (2)—506784,506783 Bathroom—506841 Bathroom—506782 Room 104 Chandelier—506848 Room 204 Chandelier—506781 Wall Sconces (2) -506847,506846 Wall Sconces (2)—506780, 506779 Bathroom—506845 Bathroom—506778 Room 105 Chandelier—506852 Room 205 Chandelier—506777 Wall Sconces (2) -506851, 506850 Wall Sconces (2)—506776, 506775 Bathroom—506849 Bathroom—506745 Room 106 Chandelier—506856 Room 206 Chandelier—506773 Wall Sconces (2) -506855, 506854 Wall Sconces (2)—506772,506771 Bathroom—506853 Bathroom—506770 Room 107 Chandelier—506860 Room 207 Chandelier—506769 Wall Sconces (2)-506859,506858 Wall Sconces (2)—506768,506767 Bathroom—506857 Bathroom—506766 Room 108 Chandelier—506864 Room 208 Chandelier—506765 Wall Sconces (2) -506863,506862 Wall Sconces (2)—506764, 506763 Bathroom—506861 Bathroom—506762 Room 109 Chandelier—506868 Room 209 Chandelier—506761 Wall Sconces (2)-506867, 506866 Wall Sconces (2)—506760,506759 Bathroom—506865 Bathroom—506758 Room 110 Chandelier—506872 Room 210 Chandelier—506757 Wall Sconces (2) -506871,506870 Wall Sconces (2)—506756, 506755 Bathroom—506869 Bathroom—506754 Room 111 Chandelier—506876 Room 211 Chandelier-506753 Wall Sconces (2)—506875,506874 Wall Sconces (2)—506752,506751 Bathroom—506873 Bathroom—506750 Room 112 Chandelier—506880 Room 212 Chandelier—506749 Wall Sconces (2)—506879, 506878 Wall Sconces (2)—506748,506747 Bathroom—506877 Bathroom—506746 Room 113 No room Room 213 No Room Room 114 Chandelier—506882 Room 214 Chandelier—506723 Wall Sconces (2)—506884,506883 Wall Sconces (2)—506722, 506721 Bathroom—506881 Bathroom—506720 Version: 14-March-2017 Page 8 of 9 GFT-OP-10b • FIELD EVALUATION REPORT FOR HORIZON ENGAGEMENT LLC Report No.: 105013179NYM-001 Date: 20-April-2022 Room Lights Room Lights Room 115 Hanging lights(2) -506832,506831 Room 215 Hanging lights(2)506744,506743 Bathroom -506830 Bathroom -506742 Room 116 Hanging lights(2)-506829,506828 Room 216 Hanging lights(2)506741, 506740 Bathroom -506827 Bathroom -506739 Room 117 Hanging lights(2)-506826,506825 Room 217 Hanging lights (2)506738,506737 Bathroom -506824 Bathroom -506736 Room 118 Hanging lights(2)-506823,506822 Room 218 Hanging lights (2) 506735,506734 Bathroom -506821 Bathroom—506733 Room 119 Hanging lights(2)-506820, 506819 Room 219 Hanging lights(2)506732,506731 Bathroom -506818 Bathroom—506730 Room 120 Chandelier—506817 Room 220 Hanging lights(2) 506729, 506728 Wall Sconces (2)—506816, 506815 Bathroom—506727 Bathroom—506814 Room 121 Chandelier—506813 Room 221 Hanging lights(2)506726, 506725 Wall Sconces (2)—506812,506811 Bathroom—506724 Bathroom—506810 Room 122 Chandelier—506809 Room 222 Chandelier—506719 Wall Sconces (2)—506808,506807 Wall Sconces (2)—506718,506717 Bathroom—506806 Bathroom—506716 Room 123 Chandelier—506805 Room 223 Chandelier—506715 Wall Sconces (2)—506804, 506803 Wall Sconces (2)—506714,506713 Bathroom—506802 Bathroom—506712 Room 124 Chandelier—506801 Room 224 Chandelier—506711 Wall Sconces (2)—506800, 506799 Wall Sconces (2)—506710, 506709 Bathroom—506798 Bathroom—506708 Room 125 Chandelier—506797 Room 225 Chandelier—5067707 Wall Sconces (2)—506796, 506795 Wall Sconces (2)—506706, 506700 Bathroom—506794 Bathroom—506705 Room 226 Chandelier-506704 Wall Sconces (2)—506698,506699 Bathroom -506703 Room 227 Chandelier-506702 4.2 Conditions of Use and Acceptability: This product is intended for use and installation in a non-classified (non-hazardous) location and for connection to the appropriately sized branch circuit. The installation methods and final acceptability at the installation site are the responsibility of the Authority Having Jurisdiction. 4.3 Schematics and Photographs: Due to the amount of the field labels quantity all pictures are stored in the EPF folder with Intertek and can be made available upon request Version: 14-March-2017 Page 9 of 9 GFT-OP-10b