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Home My WebLink AboutBLDE-23-003228 • a Commonwealth of Official Use Only E" Massachusetts Permit No. BLDE-23-003228 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:12/10/2022 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) 817 ROUTE 28 Owner or Tenant BASS RIVER PROPERTIES Telephone No. Owner's Address 817 ROUTE 28 ATTN:OFFICE, SOUTH YARMOUTH, MA 02664 !--, Is this permit in conjunction with a building permit? Yes 0 No 0 (CheckI p 6priale )5/� Purpose of Building Utility Authorization No. ;�,. � (( Existing Service Amps Volts Overhead 0 Undgrd 0 �SNt1.' ► a O New Service Amps Volts Overhead 0 Undgrd 0 �tq.pf s/� Number of Feeders and Ampacity �i // 0 M Location and Nature of Proposed Electrical Work: Install two 20 amp circuits for heat tape. v/ Completion of the,following table may be waived by , of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of ,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 2 No.of Oil Burners FIRE ALARMS No.of Zones 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 0 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 Siens 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Scott P Clifford Licensee: Scott P Clifford Signature LIC.NO.: 31558 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 12 BACK RIVER RD, BOURNE MA 025324127 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $80.00 CommomvaaLth of Massachusate Official Use Only .-,-, G-23-3Z - •' Y�' 'lJr arfm.nt e/�7 ��ii Permit No. ;r_ p Jiro-Comic. .A I I � Occupancy and Fee Checked - BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) 8 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: a-9'Z OZL 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) R.T ae O C i") tstAlSr CAp d A f Owner or Tenant 5 ,c.,`,..,......,- cop (JU+;f+S Telephone No56fi- yy•4t4i j6 t i Owner's Address Z. � M�(wclre CT, 1-kncArr�S m �jfa l:P.1 L.1' Is this permit in conjunction with a building permit? Yes El No (Check Appropriate Box) Purpose of Building rjrhe,t)q,1 Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters ,e Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: "f Reoi I -rc. \ZOVoH-ZoCas n) (:)%44.\t�S cot' NedS Tro4.e. wohr Q,pcs. v) Completion of the followintable may be waived by the Inspector of Wires. U., No.of Recessed Luminaires No.of Ce(L-Snap.(Paddle)Fans No.of Total ^ _Transformers KVA '.± No.of Luminaire Outlets No.of Hot Tubs Z Generators KVA t 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 r1Vo.of Detection and Initiating Devices II' No.of Ranges No.of Mr Cond. onsI No.of Alerting Devices No.of Waste Disposers Heat Pump Number,.Tons_,..,.,(KW _ No.of Self-Contained Totals: 1 ' Detection/Alerting Devices No.of Dishwashers Space/Area HeatingMipal KW Local❑Conner ❑Other No.of Dryers Heating Appliances KW Security Systems:* No.of No.of Water s KW No.of No.of Data Wiri gvices or Equivalent HeatSigns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: ts Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: po. op (When required by municipal.policy) Work to Startd'Z-1 -se z. 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 eovyage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 4 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: SCc!,-rt t,,W OC. . LIC.NO.: 3 1555 Licensee: 5,AYb-i.. Signature ;Q P p,i (If applicable,enter"exempt"in the license number line.) ""i'v� LIC.No.. Address: ii. I-2. Qsfli;few Rives• C.a. 0..:me.. try Cf 53 —. Bus.Tel.No.:Sob's66 Z1Sb °Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Alt Lin 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 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ J 1 •