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Home My WebLink AboutBLDE-23-001889 ,o�._. Commonwealth of Official Use Only kin v44\ Massachusetts Permit No. BLDE-23-001889 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:10/11/2022 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) 1175 ROUTE 28 Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463 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 Location and Nature of Proposed Electrical Work: Temporary services for Seaside Festival event. 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. Ton l No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertine 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 Ballasts Data Wiring: Heaters Sins 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: Jesse J Mackenzie Licensee: Jesse J Mackenzie Signature LIC.NO.: 13111 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 10 BYRON LN, S YARMOUTH MA 026644156 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: $0.00 f• "R _:_ Q I OCT0720A ., i Commonwealth o/Maddachudelie Official Use Only .w,... 23 �. C) BUILDING D' i :i>ti, : pc Permit No. ey 1 .:�:,.- i Apartmsnf of ?irs Serviced „;]<<^ Occupancy and Fee Checked 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 CM .00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /(, 7- 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) //' 7� r ,95 • s cue%aZ- Owner or Tenant l a-<-n l C»l— `Y e'at� .if ram,H,,iie Telephone No.774/ 2i6e 37el i C Owner's Address 1, 7 0 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building f A t e- Utility Authorization No. Existing Service f cc> Amps / ' l d'`/&Volts Overhead❑ Undgrd0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity ...2,-,? Locatio n and Nature of Proposed Electrical Work: l_/L.,i j e'70 1./.c!^_ 7 ", /-7='<i i v1-3 1 Completion of the following table mey be waived by the Inspector of Wires. Lb No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformersf TV KVA otal o! 'Zi No.of Luminaire Outlets No.of Hot Tubs Generators KVA r� --t No.of Luminaires • Swimming Pool 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 Detection and Initiating Devices I kJNo.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertingpevices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ � Connection No.of Dryers Heating Appliances KW Security stems:* Nof 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 Electrica Work:cl 0 _ (When required by municipal policy.) Work to Start: )0- 7'; ' 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 BOND ❑ OTHER 0 (Specify:) 1 I I_ e I certify,under the pains and penalties of perjury,that the information on this application is true and complete. I FIRM NAME: •; ,,-70 I711--hlC /�/ LIC.NO.: !slit- Licensee: 7:3 /-Hotta///e— Signature 7,,,,,,, 7f j'/E-r .— LIC.NO.: (If applicable,enter••ex pt" 'n the license number line.) Address: /67 y Ac.7,✓ L rpntz_ S• 91211.P-0-7 f! Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. i a I 1 t' 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 I Signature Telephone No. I PERMIT FEE: $