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HomeMy WebLinkAboutBLDE-20-004756 REST. or ; Commonwealth of Official Use Only -E - Massachusetts Permit No. BLDE-20-004756 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:2/27/2020 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to peitoAm the electrical work describ below. Location(Street&Number) 517 ROUTE 28 1 \l fs1 (` 0 N6:/._(--041 b. l Owner or Tenant Telephone No Owner's Address 1 A -_- _ . - -• —_ c : „w,ar 0 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check • . • , ' e ilO Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters0.66),p D:1 New Service 600 Amps Volts Overhead 0 Undgrd 0 No.of Meters i ''t,0 _______ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install two sub panels&feeders for restaurant. _ 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 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 Devices Tons 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 ❑ 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 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: RICHARD L SERPONE Licensee: Richard L Serpone Signature LIC.NO.: 6910 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 183 PINE ST,YARMOUTH PORT MA 026752374 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: $80.00 (1/ 24 't( 2-{ . II,/iY/ a7//' Commonwealth of, II,/i• Use Only �� 5 1Jeparfinent o`.tire Service! Permit No. (S� = =.;! - , =i Occupancy and Fee Checked W473 ->- BOARD OF ARE PREVENTION REGULATIONS (Rev. 1/07j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR .00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: a/„Z2 1.70 City or Town of: YARMOUTHTo the Inspector of Wires: By this application the pndersigned gives n•tice of his or her intention to perform the electrical work described below. • Location (Street&Number) - / �$' (A) t ve'c/ ' c c - z Owner or Tenant /c e/ AR,,Q 6 — /11/0 .e. Yf LL d'elephone No. e Owner's Address c1�� Cr 5 a6il/e k,N Is this permit in conjunction wi/4r-,-v�a building permit? Ys E No ❑ (Check Appropriate Box) 1 r N--- ' y`'Pur , PP j pose of Building Utility Authorization No. ? _ _ ;e /LLl fs i ting Service 4.OD Amps 7' 7 u9 Volts Overhead Undgrd❑ No.of Meters — Service Amps / Volts Overhead El Undgrd ❑ No.of Meters �N'tuber of Feeders and Ampacity I uj F• ;� lw I L(cation and Nature of Proposed Electrical Work: "' �+ / /� / J f; gift, v�00 uJ 2�oMKMaL 46i L175t�' P 7 tilt p9h t' jL TE'Pc�IP�tDI^ �j pc �f�-�17 v? 50.4 �/LCA S0.4L Completion of the following table may be waivedthe Inspector m .-.-,..,._ by P of Wires. • +io.of Recessed Luminaires No.of CeiL Susp.(Paddle)Fans No.of Total •_... .¢ ' Transformers KVA ---No. of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires swimmingPool Above In- No.of Emergency Lighting grad gr nd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of tioand InitiatinDetecg Devicnes Total ' No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump j Number I Tons I KW 'No.of Self-Contained 1 Totals:I Detection/Alerting,Devices No.of Dishwashers SpacelArea Heating KW Local❑ Municipal ' i Connection ❑ � No.of Dryers Heating Appliances , Security Systems:* No.of Devices or Equivalent No.of Water No.of Heaters KWNo.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent - Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: 3 Gt c.7.o' (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the perfonnariee 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 ❑ BOND 0 OTHER I certtfy under the a ta¢n en ❑ (Specify:) ' par'eh. �P o�.perjury,that the information on this application is true and completes FIRM NAME: ` e h.r C�ek,/ale Licensee: �/ r i i� / LIC.NO.: /�/© Signature ,‘- ' ' LLC.NO.: ,/ 46M (If applicable,enter "exempt"in the license number line. Address i Bus.Tel.No.•3o4s 3 V, J *Per M.G.L.c. 147,s.57-61,security work require D�� _ apartment of Public SafetyAlt.Tel.No.c. No.: OWNEby law.R'S INSURANCE WAIVER: I am aware that the Licensee does not havethe liability insurance coverage normally� S OwnredAgent By my signature below,I hereby waive this requirement. I am the(check one ❑owner gsa:ent.Signature ❑owner's Telephone No. PERMIT FEE: $