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Home My WebLink AboutBLDE-22-005897 -"" Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-005897 ' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked i[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:4/14/2022 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) 182 BAXTER AVE Owner or Tenant GREEN HARBOR VILLAGE LTD PART Telephone No. Owner's Address 20 N MAIN ST, SOUTH YARMOUTH, MA 02664-3150 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 ❑ 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: REPLACE 4 RECEPTACLES IN LAUNDRY WITH GFCI , REPLACE CORRODED ELECTRICAL CONDUIT IN POOL PUMP ROOM Completion of the following table may be waive by i ..- f Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of 0 of Transformers No.of Luminaire Outlets No.of Hot Tubs Generators 1♦ tr No.of Luminaires SwimmingPool Above 0 In- ❑ No.of Emergency Lighting ,7 grnd. grnd. Battery Units No.of Receptacle Outlets 4 No.of Oil Burners FIRE ALARMS No.of Zones 4 No.of Switches No.of Gas Burners No.of Detection and Initiatine 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 0 Municipal ❑ 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: Lance A Macenerney Licensee: Lance A Macenerney Signature LIC.NO.: 11149 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 126A MID TECH DR,W YARMOUTH MA 026732560 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: $100.00 vNC1I 9, fz3 r . RECEIVED • A' rAPR142orLJnwea/th o/Maeeaehuestla Official Use Only x >>D z. ` ��__ ---- - c� cc77 Permit No. -�- �a�z— 3q�/7 it " "in - '.UILDING DEPAR f.Pth{3', of ....,ire ervicea r y ,.___._-____ Occupancy and Fee Checked �/% • RE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) - APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK C All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 J (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: t 1 j 3 I-4a City or Town of: \I q(r; ..t- To the Inspector of Wires: N By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) i j,,; l wt k . try y(i t t`)‘, ed Owner or Tenant l_.'s e_ .% Telephone No. Owner's Address C_1 Is this permit in conjunction with a building permit? Yes C No E (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd No.of Meters u% New Service Amps / Volts Overhead❑ Undgrd E No.of Meters Q Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ae,Ie e . , ) t C ,.ut(( Cw.E IT E. :,e ie:). K'Q : 4 c-'i. 6,.1 0. i k'+ t l'. . A + ,' ) ICx.4 l Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil..Sus .(Paddle)Fans Transformers KVAPaddle No. f Total p No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting grad. 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 Detectionand Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ other p Connection No.of Dryers Heating Appliances KW Security Systems:4r No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Ens quivalent No.Hydromassage Bathtubs No.of Motors Total HP Tel No of Devicesoor Equiivalent 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: 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 0 BOND 0 OTHER 0 (Specify:) l C / I cernfy,under the pains and penalties of pedury,that the information on this application is true and complete. FIRM NAME: u 1 , L. irc_k"f _ Cc :. ,-r,y LIC.NO.: Licensee: -(`C c..;-z. Signature LIC.NO.: (!f applicable,enter "exempt"in the license number line.) 1 Bus.Tel.No.: 5c)X_ 1 7 5—U6 �i Address: , Li i ' v ll i v y". I`i 1 G LC 1 i 1 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)0 owner ❑owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. ep�Ctee. G F I re oho- eve.)( po.mp (bowl Re Ickee.(.2) b en 1 a r,c6cc,pe. \ k4 s