HomeMy WebLinkAboutBLDE-22-001968 Commonwealth of Official Use Only
ff Massachusetts Permit No. BLDE-22-001968
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:10/6/2021
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) 1053 GREAT ISLAND RD
Owner or Tenant JENKINS JOSEPH R TR Telephone No.
Owner's Address C/O CHRISTOPHER EGAN/CARRUTH CAPITAL LLC, 116 FLANDERS RD SUITE 2000,WESTBOROUGH, MA 01581
s this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropr'•to Box) '`
Purpose of Building .,-- z.---
Utility Authorization No. ®.
Existing Service Amps Volts Overhead 0 Undgrd 0 o,
New Service Amps Volts Overhead ❑ Undgrd 0 411.41:.‘f4Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement of 48 KW generator&add 22 KW generato
Completion of the following table may be w 0t, I os t. o ' ires.
41k4 1,"
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of
Transformers
No.of Luminaire Outlets No.of Hot Tubs Generators 2 O/ _822
No.of Luminaires Swimming Pool Above 0 In- ❑ No.of Emergency Lighting
krnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 1 No.of Gas Burners No.of Detection and
Initiative Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Ton
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 0 Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of Devices or Equivalent
Heaters KW No.of No.of Ballasts Data Wiring:
Signs 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 ❑ OTHER 0
(Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Dylan W Arsenault
Licensee: Dylan W Arsenault Signature
LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 53495
Address:2900 CRANBERRY HWY,LOT 25,EAST WAREHAM MA 025381321 Bus.lt. Tel. o..:
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.:
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: $150.00
T 14 C 4#4.a....& Official Use Only .
BOARD OF FIRE PREVENTION.REGULATIONS °�'nc
7j andgav a chard
[Rev. cleave wino
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All wodcto be performed in with the M Code(MEC),527 CMR 12.00
(PLEASE PRINT W INK OR TYPE ALL INFORMATIOA) Date: Oct 17 7/2n2)
City or Tows of: yoi ototio) To the Inspector of Wires:
By this application the undasigned eva notice of his or her intation to perform the electrical work described below.
Loadioa(Strut&Number) 1 a 5 3 G- e# ' 14(4AA4
Owner or Tenant 0pn Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes 0 No g.t (Check Appropriate Box)
Purpose of S;na to f 1:ty a1.c 11 i j$ Utility Authorization Na
Exk lag Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters
Amin / Volts Overhead❑ Uadgrd 0 No.of Meters /
Number of Faders and Ampadty j R e,Uf 1 P)6!
Location and Nature of Proposed Ekdricsd Work: REPPI,ctry' ii 1-"6er Li 8 K i 6/►G(a i i 'h
AIGw4w +�(aa441 • KIIb9., I&' h A M a1 i) i 2iLi u vJ/�64'J, t5
Gan a olds �Aw table slay beached by the
No.of Recessed Lamindres No.of Cam.(Paddle)Fans No Trandienners . KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Na of Lam s Above ❑ In- ❑ No.of y Lighting
grad. Brad. Battery Units
No.of Receptacle Outlets No.of OR Burners FIRE ALARMS IN..of Zones
(*Detection and
No.of Switches No.of Gas Burners �o`
laidathar Durkee
Total
No.of Ranges No.of Air Cond. TonsNa of Alerting Devices
No.of Waste Disposers Heat 'Number Tons 11CW
PpteoeftioniSelf-Costahaar
Na of Dishwashers Space/Area Heating KW Lori❑ ;,` ` ❑ Other
No.of Dryers Heating Appliances KR► SecurityNo.o f or Univalent
No.of Water KW 'No.of No.of Data Wiring:
Heaters Ballasts Na ofDevias or
No.Hydromsaage Bathtubs No.of Motors Total HP TekeonuntedeatleasM
Na of Device or
OTHER:
.!teach(dallied detail r or as reyat rd by the Inspector of>l
Estimated Value of • Wads (When rid by policy.)
Work to Start Inspections to be requested in accordance-with MEC Rule 10,and upon completion.
INSURANCE CO GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance operation"coverage or its substantial equivalent. The
�,.,_undersigned certifies that such coverage is in ince and has exceed proof of same to the pamit issuing office.
0 i A _ �p CHECK ONE: INSURANCE 0 BOND 0 OTHER ❑ ( ecify*
' I ,rwader the pains A ofpe, ry,that the hrfa Are this*pagan is tine aced carapace
..a. FIRM
c--c" _a
N. � (r "canon" the license number a LIC.NO.:L C.NO:: .
•
Address: I Aar C tet:+; .
ci z 'Per M.G.L.c.147,s.57-61,security' work requires Department of Public Safety"S"License: Lie.No.
w c., OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normally
re _ ._,. J , required by kw. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent.
-- Signatarat Tdephoae No. I PERAlIT FEE:$ /5-D—
u ill ( vv'cii t s +, L►'L