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HomeMy WebLinkAboutBLDE-21-006055 �,,' Commonwealth of Official Use Only to.., Massachusetts Permit No. BLDE-21-006055 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:4/21/2021 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) 277 ROUTE 6A Owner or Tenant Compass Rose Telephone No. Owner's Address 277 MAIN ST,YARMOUTH PORT, MA 02675-1817 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: Remodel Inn. Replacement of exterior lights.Wire septic system. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In-nd. ❑ No.of Emergency Lighting grnd. gr Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and No.of Switches Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices Heating Local 0 Municipal No.of Dishwashers Space/Area KWConnection 0 Other: HeatingAppliances KW Security Systems:* No.of Dryers pp No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.of Motors Total HP Telecommunications Wiring: No.Hydromassage Bathtubs 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. ��j J CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) Sbe, r- eir1-4'I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: ROBERT M SCENA LIC.NO.: 21570 Licensee: Robert M Scena Signature (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:9 Marilyn Rd,PO BOX 43,Buzzards Bay MA 025323733 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 .'-r--R.wcipsi Cot ouir e 0 M c. i-pc srup.o, bay sue,;-c Pump .//vo 141420 *(2.4 a. 2A�� ZRS7S Zb�or :y �(�4imizeiso 3o(, 3oz3c�3;2o(i ��z) �(7l u 13e3s t ti 11,(41.0,644 jams 203, 2aq,zos, ,g0,0& 01 614lr4/zf r (C1-17& Ij/41-f ee q rallotovo 201,20330/ 3024300 chAt 13°12l 7I"9r2G A'J r 9'p)i0 d>1 moor- .��� "jam Clr�x i hug /L' ZJ Official Use Only ommonwea o addac e t-__ — t c� Permit No. --r- ©,S5j- ei 2epartment o/ ire Serviced %�_�_ 1 Occupancy and Fee Checked �t4, 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: ?AY' /. 0 "Z, J City or Town of: ,k e v 12 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) 7-7 7 k'* 6. AY.,v ,-�-,o `�i p 6 r"- 1D til Owner or Tenant L h a p ' co r }►) a v S e I G a 1,.7pecc.STe gheR Owner's Address 2--7/ 2+. 6, A ye,,, fri G v h p v-r- % Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) % Purpose of Building 7.-'a 54, l ) YY 1 ) thorization No. Existing Service � Amps J / Z..LidVolts Overhead UtilityUndgrd❑ No.of Meters / �1 New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters \ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /r$7 Vc)e I v .;laml y'1 , n, A d�✓r' >7 r w c, v V--/.0.'`/Z e >) 3 h 1.",, c'i (-1, wire 5. #77 4-I v p t. )e'r t3 Completion of the following table may 6e waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA iti No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ INo.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 C Initiating Devices V k Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices Np No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW SecuritySstem s: No. y 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 Electric 1 Work: (When required by municipal policy.) Work to Start: A-0/Z.I 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the pain and penaltiesof perjug,that the information on this application is true and complete. FIRM NAME: bp'r9 f' 7-e19h 4., LIC.NO.:A4 z l 7 le) Licensee: go berr SG-e,761., Signature LIC.NO.:F zip'1 i (If applicable,pi- exempt" he license Qe,je.)in '`li 4''*'—,�us.Tel.No.•y!38'"'SP Wj Address: d "✓,7 l�lje 4'5-5 9 y✓> Alt.Tel.No.: w 2r—'7 *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: $