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Home My WebLink AboutBLDE-23-003395 #1068 RMV Commonwealth of Official Use Only £r ; , Massachusetts Permit No. BLDE-23-003395 . Massachusetts 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:12/19/2022 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) 1070&1074 ROUTE 28 (lOU ) ,t„j> avv / Owner or Tenant DAVENPORT DEWITT TR Telephone No. Owner's Address 20 NORTH MAIN ST, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes ❑ 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: Wire ductless heat pump and rooftop receptacle. 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 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 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 ofperjury,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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $80.00 I4 1.1.9-t Ol- it/ ICX Commanw*aLth o`/// �'� Official Use Only _= r ( VT$fantNo. G Z3 33`i5 w n�r and Fee Checked •' BOARD OF FIRE PREVENTIONOl�47� 22[Rev.1/07] (leaveblank) ' j APPLICATION FOR PERMIrTO'PERFORM ELECTRICAL WORK All work to be performed in accordance Gade(MEC).527 CMR 12.00 ' (PLEASE PRINT IN INK OR TYPE'ALL INFOR�M^ATION) Date: I 15 I a U City or Town of: FAY mQ�� 'Y' To the 1 ojrWires: 1By this application the undersigned gives notice ofhts or her intention to perform the electrical work described Location(Street&Number) I D 6 9 T11 G Z- � (> 12V V' I oCcAl u A ' Owner or Tenant 1l(,'l lO r--i- tit . Telephone No. Owner's Address I Is this permit in conjunction with a bonding permit? Yes ❑ No ❑ (Check Appropriate Box) r Purpose of Building Utility Authorization No. • Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters 0 Number of Feeders and Ampacity 7, 9 Location and Nature of Proposed Electrical Work: L 11t t..t1.L A- -L tM stej_f , ** (2cx •kcp(p r,.c c,,o_l. V1 Completion of the folO1 taable mr be waived by the In ra er of Wires. No.of Recessed Luminaires No.of Cell.-Snap.(Paddle)Fans Transformers KVA � No.of Luminaire Outlets No.of Hot Tabs Generators KVA Above In- No.of Emergency Lighting k No.of Luminaires Swimming Pool t r i ❑ l rnd. ❑ Battery Units . J No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Tones No.of Switches No.of Gas Burners No of Detection and z. lukfatfu>t Devices III Ili No.of Ranges No.of Air Cond. Tonne No.of Alerting Devices of Waste Heat Pump Number Tons KW— No.of Self-Contained No. Disposers Totals: Detection/AlertiuRlkvlces No.of Dishwashers Space/Area Heating KW Local 0 aairM u ipd■ ❑Other Na of Dryers Heating Appliances KW SecSystem:* of or Equivalent No.of Water No.of No.of Data Wiring: ICW Heaters Signs Ballasts No.of Devices or rivalent munications No.Hydromassage Bathtubs No.of Motors Total HP T No.of Devices or Egeivalnt OTHER: Attach additional detail if desired or as required by the hmpector of Wirer. 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 ❑ BOND 0 OTHER❑ (Specify:) I certify,under theodns and penalties of perjury,that the bsformalion on this application is one and complete. FIRM NAME: I-1A l�II et( cE I e do c ('U Y-Yv Oan LIC.NO.: f�II(ifq Licensee: (l�YIC t' r r 4r91cet1> > LIC.NO.: (If applicable,suer" In the license Tre.) Bus.Tel.No. 'Jv`C-77 S-Ck)30 Address: 1, 1Ae" I Te, t' ' , /21m1ci. Att.Tel.No.. *Per M.G.L.c.147,s.57-61,security work requires of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage norrmlly required by law. By my sore below I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent Owner/Agent __G� PERMIT FEE:$ Signature Telephone No. ,}C