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Home My WebLink AboutBLDE-23-002982 RMV #1084 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-002982 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:12/1/2022 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) 1080 ROUTE 28 Owner or Tenant MASS DOT(RMV) Telephone No. Owner's Address 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: Install 2 exterior wall packs&electric heat in bathrooms. (1084 Route 28) 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 2 Swimming Pool Above 0 In- ❑ No.of Emergency Lighting grnd. rnd. 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 ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances 2 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 ❑ 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $80.00 CUL�- � �l ECF'iIfED . .. _1,I---- NOV C nh /rt i Official Use Only 2 ammam..a a/ a< a�.r nn Permit No. f13- �pp 1 Z BUILD! , w w MENT 2)apartnumi of,}in Jeraicaa ;� Occupancy and Fee Checked BY. s. .•e RD OF FIRE PREVENTION REGULATIONS [Rev.1/0 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK so C All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 v (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1l/3 'i/r a City or Town of: V0.r(V10 tk H To the Inspelctor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 10 gy e+e. 8 (B,,1d,n9 5pctee Ci,D5E5-1/4- is-0 kW Den,\,s) L Owner or Tenant m ass R c�i S{-r y oc T\ {0 r /t.lei c(r'S Telephone No. —32 Owner's Address Is this permit in conjunction with a building permit? Yes El No ❑ (Check Appropriate Box) Purpose of Building C U Yr\YYl C(I(.--c--1 Utility Authorization No. 9)) Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters U 4 New Service Amps / Volts Overhead El Undgrd❑ No.of Meters Number of Feeders and Ampacity 1 London and Nature of Proposed Electrical Work: �h5�0.<t a eX`_rt 0( v\I0,U pc,c_ .S 0 r\ffn.� o-f t lAj nct, —I—n S{-a l l of e Iec_f,H c, 11eC t 5 t r.,e,'t ry 41,-,(eomS Completion of the following.table may be waived by the Inspector of Wires. Li) No.of Recessed Luminaires No.of Ceti.-Sasp.(Paddle)Fans No.of Total t Transformers KVA G1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA a No.of Luminaires Swimmin Pool Above ❑ In- ❑ Na.of Emergency Lighting g grod grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones Z No.of Switches No.of Gas Burners No.of Detection and Initiating Devices 11.1 No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Dis rs Heat Pump Number Tons KW No.of Self-Contained ......................... Totals: Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local❑Municinnpalection ❑OtherC Na.of Dryers Heating Appliances KW Secustems:* rity o y of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or EWquivaglent No.Hydromassage Bathtubs No.of Motors Total HP 'Telecommunications N of Devices orEquivalent 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete.[ I FIRM NAME: :.(t ex- ee�+ i e (v.\ cm LIC.NO.: A l i i V I� Licensee: LQYlee- rn0.0 L-ieCne/ Signature LIC.NO.: (If applicable,enter"exempt"in the licensq numbe liie.). I Bus.Tel.No.'(50$_) 7-7 S-00 30 Address: 1...).10 ] (')d Te c.l� Or i.ya ran o r-Th 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:$ tY(?CO Signature Telephone No. SS@C <! ; V':IV