HomeMy WebLinkAboutBLDE-23-005397 RM 6 Commonwealth of Official Use Only
FE'_ `i Massachusetts Permit No. BLDE-23-005397
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
(Rev.1/071
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:3/30/2023
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) 37 NEPTUNE LN
Owner or Tenant VRI DEVELOPMENT&SALES Telephone No.
Owner's Address RIVERVIEW RESORT,PO BOX 399,HYANNIS,MA 02601
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: Replace devices on exterior walls.(Room 6)
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 i ❑ No.of Emergency Lighting
grnd. g ra d. 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
bons
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 U 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: Lance A Macenemey
Licensee: Lance A Macenemey 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:$100.00
(L)C6A 4(3(23(
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II Official Use Only
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�4 — Occupancy and Fee Checked
-.= BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07} v
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,agesAPPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
AU 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: 3/ 3L /3
City or Town of: 'ktr pv 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) ?17 ph&wive, L n �;�',�,.- (,
Owner or Tenant R j YP�vie,,AI k Sor-(-- Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes i l No I I (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead n Undgrd ri No. of Meters
New Service Amps / Volts Overhead P Undgrd I No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: ��PJadta— Iiit irtievl and d vas 0 •e--X.kr-ior.
\tl,k, 1 Ls (6 tom ,
Completion of the followintable may be waived by the inspector of Wires.
otal
No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No.rof TVA
Transformers KVA
No. of Luminaire Outlets No. of Hot Tubs Generators KVA
No. of Luminaires Swimming Pool Above ❑ In- n No. of Emergency Lighting
grnd. grnd. Battery Units
1
No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones
No. of Detection and
No. of Switches _No. of Gas Burners Initiating Devices
No. of Ranges No. of Air Cond. Total No. of AlertingDevices
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 n Municipal n Other
Connection
HeatingAppliances Security Systems:''
No. of Dryers pp KW No. of Devices or Equivalent
V No. of Water KW No. of No. of Data Wiring:
Heaters Signs.___ __ Ballasts No. of Devices or—Equivalent uivalent
No. Ilydromassage 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: 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 IX BOND ❑ OTHER ❑ (Specify:)
I certify, under the pains and penalties of perjury, that the information on this application is true and complete.
FIRM NAME: Fu t l fJ LIC. NO.: A 1t (Li
C.. (
Licensee: L4 \e.e. mCk -exc,_y Signature LIC. NO.:.
(If applicable enter "exempt" in the license number line.) Bus. Tel. No.: 'O$ - -77 5—UC3f
Address: I tQ ( c . T�c-k . Nib(i' lD t 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) El owner ❑ owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $ 1 UG