HomeMy WebLinkAboutBLDE-22-004062 tor . Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-22-004062
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.I/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:1/24/2022
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention tccrforni the electrical work described below.
Location(Street&Number) 97 SOUTH SHORE DR UNIT 213
Owner or Tenant SHORE ROAD ACQUISITION LLC Telephone No.
Owner's Address C/O NEWPORT HOTEL GROUP, 28 JACOME WAY, MIDDLETOWN, RI 02842
Is this permit in conjunction with a building permit? Yes 0 No 0 (Cheep Ap�prte Box)
Purpose of Building Utility Authorization No. %r�ty 'f' ' /'"\
Existing Service Amps Volts Overhead 0 Undgrd 0 �.`., .004
PUndgrd �� e,
New Service Amps Volts Overhead 0 0 T
Number of Feeders and Ampacity °�1 2
V/"`�I
Location and Nature of Proposed Electrical Work: Replacement HVAC. ,) '('' "'
N.,•,* -.>
Si2
Completion of the following ta3ig.
t I i.r of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of 4rotal
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators ) C.2 KVA
No.of Luminaires Swimming Pool Above ❑ In- I: No.of Emergency Ligh rI ng
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners 1 No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. 1 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 of perjury,that the information on this application is true and complete.
FIRM NAME: Kung-Po Tang
Licensee: Kung-Po Tang Signature LIC.NO.: 21928
inapplicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 518 COTUIT RD, MASHPEE MA 026492351 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: $50.00
RECEIVED QQf /
--1,o ealth of kamachudetta Official Use Only
JAN 212022 Permit No. eZZ— GPO lc,�
ep riment o/.7ire Service,
i p URUA e Occupancy and Fee Checked
k.,, _ BOA O Rk REVENTION REGULATIONS [Rev. 1/07] (leave blank)
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:1/20/2022
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 befog\.
Location(Street&Number)97 South Shore Dr.
Owner or Tenant Ocean Mist Telephone No. 386-747-9665
Owner's Address
Is this permit in conjunction with a building permit? Yes n No 0 (Check Appropriate Box)
Purpose of Building Commercial Utility Authorization No.
Existing Service Amps / Volts Overhead 0 Undgrd❑ 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: fHVAC units replacement. Unite' -s---- -
Completion of the followingtable may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Transformers KVA KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires SwimmingPool Above U In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
of
No.of Switches No.of Gas Burners4 No. InInitiatinnggon Dete and
Devices
No.of Ranges No.of Air Cond.4 Total No.of Alerting Devices
g Tons
No.of Self-Contained
No.of Waste Disposers Heat
Totals Number Tons KW Detection/Alerting Devices
Municipal
No.of Dishwushers Space/Area Heating KW cal❑ Connection ❑
Lo Other
Heating Appliances K«' Security Systems:*
No.of Dryers g PP No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No,of Devices or Equivalent
dromassa a Bathtubs No.of Motors Total HP
Telecommunications Wiring:
No.H
Y g 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:1/18/2022 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 0 (Specify:) Email Address
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: �� LIC.NO.:21928-A
Licensee: Kung-Po Tang Signature — LIC.NO.:52286-B
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:781-68s-75°6
Address: 518 Cotuit Rd.Mashpee,MA 02649 Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires D merit 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 0 owner's agent.
Owner/Agent PERMIT FEE: $
Signature Telephone No.