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Home My WebLink AboutBLDE-23-000064 , ; Commonwealth of Official Use only �` 0Massachusetts Permit Na BLDE-23 000064 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:7/6/2022 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) 518 ROUTE 28 Owner or Tenant SANDBAR HOLDINGS LLC Telephone No. Owner's Address 518 ROUTE 28, WEST YARMOUTH, MA 02673 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 ❑ 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: Undefined scope of work. ("Low Voltage") 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 0 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 ❑ 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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: $115.00 Cs—k.V G 6.; d-6 I.1‘j' 6 -11F (�1 6-- OP- EV EAK-C4 'c S ' ( (9 6-- tif ,, SLN Commonwealth of rr/aeeachusaRs Official Use Only =R 4= . cc'77� cc-77 nn tit G Cl ; =tr—,'. .1Jr arimrni of Jin Jiwrus Permit No. 3 a i=a' Occupancy and Fee Checked „ " BOARD OF FIRE PREVENTION 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 Cl IP •ASE PRINT IN INK OR TYPE ALL INFORMATION) Date: a;AYIy a3, sous W W City or Town of: \0.r v ou.'*-I, To the Inspector of Wires: aTy!his application the undersigned gives notice of bias*Iva intention to perform the electrical work described below. `"CS I.,,,.non(Street&Number) 5 8r4'c&s y `J-`T,I 1A)pN �QlrF4Qi.L t1n 1 Ill Ft C�d(o73 W nt cc 13, , Cod -Tv, Pf -.\-ca e, 0 eAr tb-1 Telephone 5 q as er or Tenant 0. Te hone No. 00,-(7L(pole O Z 4 '.er's Address W - , a permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) . e of Building Utility Authorization No. - ,r ng Service Amps I Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity 1 Location and Nature of Proposed Electrical Work: � Completion of the followingtable maybe waived by the/ etor of Wires. ItNo.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of Total t Transformers KVA G) No.of Luminaire Outlets No.of Hot Tubs Generators KVA a Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool crnd. ❑ grnd. ❑ Battery Units • No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones rt No.of Switches No.of Gas Burners No.InDete and 'Z Initiatinngg Devices es t l i No.of RangesNo.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Dis rs Heat Pump Number Tons KW 'No.of Self-Contained Pow Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municnnectiipalon ❑other, Co No.of DryersHeating Appliances KW Security Systems:" No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Teleccng: o.of unicatsoor Equns ivalent OTHER: LO v- s i Vo I'L- t' A- Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: ,J (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 Ei BOND ❑ OTHER 0 (Specify:) I certify,under the pains pnd penalties o fperjgry,that the information on this application is true and complete. �SC Vve..FIRM NAME: r 2 Y ) t U LIC.NO.: Licensee: exe,(Vv.-A- Signature LIC.NO.:(If applicable,enter"ererlpl"in the license number line.) ( Bus.Tel.No: ' I.507 T T p 7.73 Address: 159 Fril cat a,.'ttt R.I IN OSY101?e_ ✓K Icl C (441 Alt.Tel No.: *Per M.G.L.c.147,s.57-61,security work requires Depsrdttent 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.B my si below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Age Signature Telephone No.,1-V JJ(G 3�1 '67 PERMIT FEE:$ ICJ,