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HomeMy WebLinkAboutBLDE-22-001729 #212 a•�- Commonwealth of Official Use Only fi:: t Massachusetts Permit No. BLDE-22-001729 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:9/27/2021 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) 237 NORTH MAIN ST Owner or Tenant DAVENPORT DEWITT TR Telephone No. Owner's Address DAVENPORT REALTY TRUST, 20 NORTH MAIN ST, SOUTH YARMOUTH, MA 02664-3150 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 At Location and Nature of Proposed Electrical Work: Renovations ` _1 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 Initiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No No.of Devices or Equivalent HeatersWater KW No.of No.of Ballasts Data Wiring: Sion 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LANCE A MACENERNEY Licensee: Lance A Macenerney Signature LIC.NO.: 11149 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 126A MID TECH DR,W YARMOUTH MA 026732560 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: $80.00 �' r E-0-a. Mt u ep (c.J e f f�p�'a r ZG- r (3-iC�1 9 /z7 L Y4. • ~ r 2 4 2021 •mmona ea[lh.ol///aadac ttd Official Use Only � , f ( 2Z-1 9 Z ! cc'�� ((7� Permit No. = ,is i y D r_F A R 1 1 E 1V T spart►nent o1.}ira Jewrces `='s►.. '• :e ` - . RE PREVENTION REGULATIONS Occupancy and Fee Checked [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: R ,r `) Cityor Town of: � 'K To the Inspector of ires: By this application the undersigned gives notice v f of his or her intention to perform the electrical work described below. Location(Street&Number) .;13 7 t tt,IN 5.t u - 4- a l a nt v Owner or Tenant (r i c `��c Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No � Purpose of Building ❑ (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undg rd❑ No.of Meters v j New.Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters � Number of Feeders and Ampacity ® Location and Nature of Proposed Electrical Work: �(' 1t1VA 4-; 0/1 S +© LtYltt Completion of the.followinktable may be waived by the I f 1or of Wires. Vv No.of Recessed Luminaires ) No.of lb No. of Cell.-Su sp•(p addle Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmingpool Above In- .No.of l mergency Lighting and. ❑ grad ❑ Battery Units No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS JNo.of Zones No.of Switches No.of Gas Burners -No.of Detection and 11 No.of RangesTotal Initiating Devices No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number(Tons I IOW No.of pelf-Contained Totals: """"" " """ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water , No.of No.Heaters Signs Ballasts No.of Devices or Equivalent of Data Wiring: 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: (When r Work to Start: required by municipal policy.) 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:) Icertify,under the pains and penalties ofperjury that the information on this application is true and complete. FIRM NAME: }�.t I l e.< F I e c_A-r-,e n m any T o LIC.NO.: 1-�nee ,n ,�-1 Licensee: I ,/l n e�n e Signature r LIC.NO.: (If applicable,enter"exem t'in the license erline.) Address: i d e l„ Bus.Tel.No.. - 8' -7 dO3Z) *Per M.G.L.c 147,s 37 61,security work requires D 1. Alt.TeL No.: License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does c Safety the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one owner owner's ent. Owner/Agent Signature Telephone No. PERMIT FEE: