HomeMy WebLinkAboutBLDE-23-000024 Commonwealth of Official Use Only
tE '' Massachusetts Pennit No. BLDE-23-000024
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:7/2/2022
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) 518 ROUTE 28
Owner or Tenant SANDBAR HOLDINGS LLC
Telephone No.
Owner's Address 518 ROUTE 28, WEST YARMOUTH, MA 02673
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check
Purpose of Building Appropriate Box)
Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 0
New Service gNo.of Meters
Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Connect new pizza oven hood to existing fire alarm system.(SHARK BITES)
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- ElNo.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiatine Devices 1
No.of Ranges No.of Air Cond. Total
Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained
Totals: Detection/Alertine Devices
No.of Dishwashers Space/Area Heating KW Municipal Local ❑ P 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:
OTHER:
No.of Devices or Equivalent
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 andpenalties o
f perjury,that the information on this application is true and complete.
FIRM NAME: Robert K Boucher
Licensee: Robert K Boucher Signature
LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 1317
Address:218 SETUCKET RD, YARMOUTH PORT MA 026752258 Bus.lt. Tel.No.:::
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.
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 ❑ owner's agent.
Owner/Agent
Signature Telephone No.
'PERMIT FEE: $115.00 I
— -
Commonwealth of Massachusetts Official Use Only
Permit No.
a:_r Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. 9/05] (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: 6/29/22
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) 512 Main Street Route 28—Shark Bites Restaurant
Owner or Tenant Cape Cod Family Resort
Telephone No.
Owner's Address Same
Is this permit in conjunction with a building permit? Yes X No (Check Appropriate
ppropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ fl Undgrd g I I No.of Meters
New Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Add new pizza oven ansul hood to existing fire alarm system
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 1
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices 1
Tota
No. of Ranges 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: j Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal
Connection ❑ Other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of No.of Devices or Equivalent
Heaters KW No.of Data Wiring:
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: 5o0
(When required by municipal policy.)
Work to Start: 6/29/22 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 X BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information o this appli tion is true and complete.
FIRM NAME: Seaside Alarms inc. �
Licensee: Robert K. Boucher //,
LIC.NO.: 1317C
(If applicable, enter "exempt"in the license number line.) Signature LIC.NO.:
Address: 1265 Route 28.South Yarmouth MA 02664 Bus. Tel.No.: >OR-i94 0599
Alt.Tel.*Security System Contractor License required for this work;if applicable,enter the license number here:No ••
S-0046
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 a
Owner/Agent
Signature ent.
Telephone No. PERMIT FEE: $