HomeMy WebLinkAboutBLDE-21-001065 UNIT F aF Commonwealth of Official Use Only
filltki
Massachusetts Permit No. BLDE-21-001065
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:9/1/2020
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) 24&32 COMMERCIAL ST
Owner or Tenant KIMBALL PETER V TR Telephone No.
Owner's Address COMMERCIAL YARMOUTH NOM TRUST,84 HOMERS DOCK RD,YARMOUTH PORT
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check 4.,pr s pri e O �j►
Purpose of Building Utility Authorization No. (••//
Existing Service Amps Volts Overhead 0 Undgrd 0 . , , net h
7.
g ,
New Service Amps Volts Overhead 0 Undgrd 0 No. , •
Number of Feeders and Ampacity 4114 '
Location and Nature of Proposed Electrical Work: Upgrade lighting U ,J a t:: _
P P9 9 9- . __�. �,-�
Completion of the following table may be waived by the InspeOf 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- Q 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 0 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 Siens 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 ofperjury,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 ❑ owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$80.00
Via, (74
Commonwealtie ol Maddac4u.deti.d Official��Use Only
'' - * -4't cc�� c'� Permit No. i (n(CA.'''.
me 2)Apartineret o� }ire Serviced
!i 4 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
a:,�,�• [Rev. 1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code ),527 R 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: t 11 -O -
City or Town of: To the Inspector of ires:
By this application the undersigne gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) D---Co-"Vt1.424L.424 0..K. 1-- f
Owner or Tenant L.I.. V Telephone No.q/ y - 4g 7
Owner's Address G ' q�'vi
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 ❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead 0 Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: ikee laze, gdiQ,e-9 y - i „~ J
Completion of the following table may'bebe waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans TfTotal
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No,of Luminaires Swimming Pool Above ❑ In- 0 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 AlertingDevices
Tons
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other p
Connection 8888
No.of Dryers Heating Appliances KW ' ecNo uris:*
of DeviSysteces 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: A-SdiInspectionsai;eha.requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVE GE: 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 f' BOND 0 OTHER 0 (Specify:)
I certify,under t epains and penalties ofperjury,that the information on this application is truu and complete.
Y� ��e,
FIRM NAME: Ai f C �..-t > )L LIC.NO.:
Licensee:—?/ n ode- /^%-4 Signature y* LIC.NO.: I''j 5)0 p4—
(Ifapplicabl nter "exempt"in the license number line.) Bus.Tel.No.:
Address: 4r k .2 /3 ,s a9- A-,%4o.e4_ pi ' 2 f-6/ 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)❑owner ❑owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $ 0 D
p M ial.L/ax4s-i.'' # ��
� mil,