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HomeMy WebLinkAboutBLDE-22-001387 . -.. _; .: Commonwealth of Official Use Only
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' Massachusetts Permit No. BLDE 22 001387
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• 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:9/10/2021
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) 9 COMMONWEALTH AVE
Owner or Tenant Five Star Transportation Telephone No.
Owner's Address 9 Commonwealth Avenue, South Yarmouth, MA 02664 O
Is this permit in conjunction with a building permit? Yes 0 No 0 (Che r i prt y)
Purpose of Building Utility Authorization No. 0
Existing Service Amps Volts Overhead ❑ Undgrd 0 10 I ; 1 •t•
New Service Amps Volts Overhead 0 Undgrd 0 j'Qt rik ficfb
Number of Feeders and Ampacity / IF
/?
Location and Nature of Proposed Electrical Work: Upgrade lighting. (5 STAR TRANSPORTATION-9 Commonwealth Avenue)
Completion of the following table may 3a' d ''ctor of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of ` i al
Transformers / / A
No.of Luminaire Outlets No.of Hot Tubs Generators / KVA
3
No.of Luminaires Swimming Pool Above ❑ I ❑ 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
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 ❑ 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 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Paul M Morris
Licensee: Paul M Morris Signature LIC.NO.: 17520
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:PO BOX 213,1 COUNTRY WAY,SAGAMORE MA 025610213 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:$80.00
N
1
&\ l.00mmoneoectan.alet7f taiiaaJcf reset`t:3 ('Official Use Only t/�P.e��I 5t dJe arfinerst o .}ire Serviced
Permit No.\'���` ~,�`(!)
_=° P `7
Ti-- kOccupancy and BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 (leave
e blank)
Checked
•n'�� � (leave blan
APPL C A TVIN FOR PER AT TO PERFOr ELECT!"MAL @r'�Ytor-;k
All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) ,Date: $ a.'?) I'a--p
City or Town of: p,�,j1,-.. To the Inspectott of Wires:
By this application the undersigned eves notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 1 b '., (Y\(v-N.o rl LAIC-A"L t'v 11 P A".l.)€
Owner or Tenant S 5-h[>r(L_.-'r216k-1.5 p,g(4, -1_D t� Telephone No.'--/�7'.j ?j ss
Owner's Address � ✓1-c,. ;-'p'p pr`- - �3,X J
Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box)co
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd
❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: y t'
J /AAA.Ate__ p�iLl12i�6r 2n f ed k�l
U ® 1 1
Completion ofthe,follmning table maybe waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil.-Sus . No.of Total
p(Paddle)Fans Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool gAbove 1-1 In ❑ No.of Emergency Lighting
Arad. -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
No.of Ranges Total Initiating Devices
No.of Air Cond. - Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump Nm uber Tons I KW. No.of Self-Contained
Totals:I ""` ''— Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Municipal.
No. Local❑Connection ❑Other
No.of Dryers Heating Appliances Security Systems:*
No.of ater KW No.of No.of Devices or Equivalent
Heaters
No.oi' Data Wiring:
Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total tiP Telecommunications Wiring:
OTHER: No.of Devices or Equivaelent
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 A-a--0-49 Inspections 1»re 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 ceiTify,under the pains and penalties of perjury,that the information on this application is trite and complete.
FIRM NAME[P N fni FA e c -rti c_.. . 1 C..
i �, LIC.NO.:
Licensee:—p :/ ®f,-.Al Signature
i.:., LIC.NO.:1'75 A
(Ifapplicablea,,y�nter"exempt"in the license number line') Bus.Tel.No...6-bE-`77&"al if
Address: 61 2/I t -, d145 Ai Pt— G 9 / 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)❑owner ❑owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:SS 'R.b.C7J
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