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Home My WebLink AboutBLDE-22-006604 planet fitness Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-006604 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:5/17/2022 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) 7 LONG POND DR Owner or Tenant TARLIN LLOYD DS & I RABB&GOLDBERG A Telephone No. Owner's Address C/O STOP&SHOP SUPERMARKET CO, 1385 HANCOCK ST RE DEPT, QUINCY, MA 02169 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: Replacement F.A.C.P. (PLANET FITNESS) 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 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 Totals: Detection/Alerting 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 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 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: David Canuel Licensee: David Canuel Signature LIC.NO.: 20686 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:35 HERITAGE DR, ATTLEBORO MA 027035403 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: $115.00 5( 1 6 I 4c ass i z� �t�Gl��►vt tlVn `v c :c cam, 14 Commonwaa[th o1ae�saca Official Use Onlyr /� �� tt��rr�� cc77 {� Permit No. �%C`e 0 i • Ag' �L)spantnssnf o� iin Jarvits! 11147 Occupancy and Fee Checked Z 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 TY E ALL INFORMATION) Date: j/��122-_ Cityor Town of: Arrn(An, To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. `I-- Location(Street&Number) 1 r � R 6 tar 0 02 Owner or Tenant I �GU1 .t lYlfss I a�liY1 EI G�s"r-�. Telephone No..SO2,2-5-5-S7.2 ..._. Owner's Address /7 /p At/ P&a'Yi IR.c �-t_finoci'+ /')1C' 4:,,,, Is this permit in conjunction with a building permit?Purpose of Building & Yes 0 No (Check Appropriate Box) yl� Utility Authorization No, Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters 4 New Service Amps / Volts Overhead C Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: S 1,,,1A., E t o 4 Ctt 1-e 1-32.0 e I �-1 t�L._ Wit+(" b i d"C s olp i=f Completion of thefollowingtable may be waived by the Inspector of Wires. Total I' No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Tf Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting �rnd. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 1 of No.of Switches No.of Gas Burners No. InDetection and Initiating Devices i.` No.of Ran es No.of Air Cond. Total No. of Alerting Devices g No. Disposers Heat Pump Number Tons KW.......... No.of Self-Contained No.of Waste Dis po Totals: Detection/.�, t evicesy No.of Dishwashers Space/Area HeatingKW Local L. nicipl other p yyonnech t No.of Dryers Heating Appliances KW Security Xstem Devices or Equivalent No.of Water No.of N Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: Y g No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of 1 ctr'c l Work: 6M0 (When required by municipal policy.) Work to Start: 21 Z Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C GE: 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 ains and pe hies of rjury,that the Information on this application is true and complete. FIRM NAME: C- (V v LIC.NO.: Licensee: pm k l u-e Signatu 1 LIC.NO.: 20 Cn __ (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.• Address: Alt.Tel.No.: Z. 3- *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 coves ormally required by law. By m re ,I hereby waive this requirement. I am the(check one)0 owner i.Vowner's a ent. Owner/Agent �! �$1�Lf PERMIT FEE: $ I1, 'o Signature Telephone No. ,