The URL can be used to link to this page

Home My WebLink AboutBLDE-20-005793 a Commonwealth of Official Use Only E.,,t Massachusetts Permit No. BLDE-20-005793 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:5/13/2020 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) 817 ROUTE 28 Owner or Tenant KIM HOLDINGS LLC Telephone No. O Owner's Address DBA CAPT GLADCLIFF, 817 ROUTE 28 ATTN:OFFICE, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ak; 'ate < l Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No. .' t• s0 0 ..."/ New Service Amps Volts Overhead 0 Undgrd 0 No fOri.......‘ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Renovations to unit 19. 72/7 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 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/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 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 ofperjury,that the information on this application is true and complete. FIRM NAME: Scott P Clifford Licensee: Scott P Clifford Signature LIC.NO.: 31558 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 12 BACK RIVER RD, BOURNE MA 025324127 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: $100.00 gA)ceE 5-((3(ze t 12c( r_ ___ (—L.),\‘ tA=.,\\ W r'?--r. ce.o`d r co, ..aK 0/Maesactget.t/a �2�Use 7q � rd •r cc77�� J 4 Permit No. • � .[J ..tins Jsrvicsd Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: PS- 5 - a a City or Town of: ` \c c m o vac In To the Inspector of i " ,� I, By this application the undersigned gives notice of his or her intention to perform the electrical w pv. it T Location(Street&Number) SS CI 0,-r a$ V v,i-4 - \q 'x .: " 9) Owner or Tenant >c,3 d 1Qc to'S T on }' '`-- O' Owner's Address *a 1-lnxl-No\rn R �a`�C 49?() i'' -v Is this permit in conjunction with a building permit? Yes 0 No 1 (Check f sPurpose of Building Utility Authorization No. _ `j`� j Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters v Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 'Tr\g�.P,\1`►nc1 -R ov\i-vic c n cl ck\E`.., s.z ti.: h...,.; n 5 I i'ns.S ., cr\o e_ o'22o v C\ i- k:-k- ,esr\ �-Yo,- . . New k: tire, \tgwT , Completion of thefollowingtable may be waived by the Inspector of Wires. Total L No.of RecessedKVA Luminaires No.of Ceil.-Snap.(Paddle)Fans To.of Transformers KVA Q No.of Lnminake Outlets No.of Hot Tubs Generators KVA 4: No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of erEmergency Lighting g 1prnd, arrnd. Battery Unit ar. No.of Receptacle Outlets No.of OH Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners lnitlitins Device IA.' No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons otals: _ (KW _ NeD of ertln pelf-Contained No.of Dishwashers Space/Area Heating KW Local 0 C 0 Other No.of Dryers Heating Appliances KW SecN rfty Systems:* o.of Devices or Equivalent No.of Water , No.of No.of Data Wing: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP 'TelecommunicationsDevicer W y n Na of Devices or Eg2Sent OTHER: Attach additional detail if desirect or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 5'-1 -'L c t O 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 coyerage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE I:I 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: S cc r C..' C O K-(ii- LIC.NO.: 31 W S-S Licensee: Sic)r rr Signature E--).-... t. LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:50'- 54 `Z-71-C. Address: # I a 1`-e=+ n�1' Sr ,er\',d Zs,re,b O'c O 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 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$