HomeMy WebLinkAboutBLDE-22-005154 'of. '''' q/156 Commonwealth of Official Use Only
itt.'11% Massachusetts Permit No. BLDE-22-005154
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:3/16/2022
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) 97 SOUTH SHORE DR UNIT 1C
Owner or Tenant OCEAN MIST LLC Telephone No.
Owner's Address C/O NEWPORT HOTEL GROUP, 28 JACOME WAY, MIDDLETOWN, RI 02842
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 ❑ Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install five E.V.charging stations.
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 TotalTransformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grrnd. grnd. Battery Units
No.of Receptacle Outlets 5 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
P Totals: Detection/Alertina Devices
Space/Area HeatingLocal ❑ Munici al
No.of Dishwashers P KW Connection 0
Other:
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 Signs No.of Devices or Equivalent
Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
required bymunicipal policy.)
Estimated Value of Electrical Work: (Whenq p p y'
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: ROBERT D GREER LIC.NO. 26793
Licensee: Robert D Greer Signature
(If applicable,enter"exempt"in the license number line.)
Bus.Tel.No.:
Address: 140 PEACH TREE RD, MARSTONS MLS MA 026481841 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 re'. - aw.But my
signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent.
Owner/Agent VIM
Signature Telephone No. PERM FEE: $80.00
Thc it ef4A u1r 0 7h,bz/i: -- =IP
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1 ECEIVED
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Commonwealth of t'//addach�cdetts Official Use Only
I MAR 1 �' _�_
c'� �cc77� ) , 1
l A 2eparfmcnrt . `ire Serviced Permit No. ( �`}'
l:�= ' o BUILDING U I L(U I N C� iJ r T Occupancy and Fee Checked _
_ _;._ BOARD OF FIRE PREVENTION REGULATIONS
ev. 1/07] eave blank
APPLICATION FOR-PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code NEC),527 CMR 12.00
(PLEASE PRINT IArWK OR TYPE ALL INFORMATION) Date:________ ______La
a
City or Town of: YARMOUTHe Wires:ector of
By this application the undersigned gives notice of his or her intention to perform the�ctrical work described below.
Location (Street&Number) 73-" .� A D ri: 6 r
Owner.or Tenant
Owner's Address � Telephone No. �� t�d j/
Is this permit in conjunctio with a building p Yes No �/
Purpose of BuildingI
— L (deck Appropriate Box)
! " "�� Utility Authorization No.
Existing Service, d 11 Amps J Volts Overhead 0 Undgrd�' V/ No.of Meters
New Service Amps / Volta Overhead❑ Undgrd
Number of Feeders and Ampacity ❑ No,of Meters
Location and Nature of Proposwl Electrical Work: '-
,5 4-4` ion 0 r1 P4 rk�vl z�v �` ti'"✓
Completion theof
��d'
following table may 1fe waived by the Inspector of Wires, oe
No.of Recessed Luminaires No.of Cei1.-S (Paddle)Fans No.of Total
�• Transformers gVA
No.of Luminaire Outlets No.of Hot Tubs -
Generators ICVA
No.of Luminaires Swimming Pool Above ❑ In_ �No.of Emergency Lighting -
-
:rnd. °rnd_ � Battery units
No.of Receptacle Outlets No.of Oil Burners
FIRE ALARMS INo.of Zones
No.of Switches No.of Gas Burners No.of Detection and
No.of Ranges To
Inmatnnz Devices
No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Low❑ Municipal
Connection ❑ Other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water No.of
Heaters ' No.of Data Whin
Shots Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
OTHER No.of Devices or Equivalent
L 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: IZ Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE C RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability' surance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such c•v .ge is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE 2 BOND ❑ OTHER 0 (Specify:)
I certify, under the gins and penalties o perjury,that the information on this application is true and complete.
FIRM NAME: n.6(0 t P `Pen
Licensee: ! LIC.NO.: `Z
Signature gel/li;�i,v cZI. LIC.NO.:
(Ifapplicabl te�r '•_exempt in the licence r line.) f/Address: �G1i`tY`eb� /�cfP,7L6115' ///r//S / C ��p Bus.Tel.No.- I r W ►��
J Per M.G.L.c. 147,S.57-61,security work requires Department of Public SafetyAlt.Tel.No.
OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liabilityLin.No.."—____ -----
-
� law. insurance coverage n �ly
S re required
Agent By my signature below,I hereby waive this requirement I am the(check one ❑owner ❑owner's a env
Telephone No. PERMIT FEE: $ cf0i