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Home My WebLink AboutBLDE-22-003782 #6 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-003782 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:1/7/2022 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) 107 SOUTH SHORE DR Owner or Tenant KJ INGOLD LLC Telephone No. Owner's Address CIO SURFCOMBER MOTEL, 112 SOUTH SHORE DR, SOUTH YARMOUTH, MA 02664 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: Fan, light, &receptacle.(UNIT 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 1 Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 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 ❑ 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 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.57-6 I,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 ACommoncvealfk o/Ma36ac Lett6 Official 1....se Only r r" cc�� Permit No.; 2spartmeni o/ ire�eruices ' �'' 1 1'S BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1p/0 Occupancy and Fee Checked RJ "`' i" (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 L.I --j (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ( ( i t a City or Town of: 'VC{k�f O t. To the Inspector of Wires: col By this application the undersigned gives notice of his or her intention to perform the electrical work described below. IJi Location(Street&Number) O ��}� I\a(c- -OrE- C...; 1 Owner or Tenant j, r Ca; lr\ht,<- Telephone No. C�+ Owner's Address A Is this permit in conjunction with a building permit? Yes C No (Check Appropriate Box) ! Purpose of Building Utility Authorization No. J — Existing Service Amps / Volts Overhead Undgrd g Li No. of Meters �E I (....1.,1 New Service Amps / Volts Overhead C Undgrd ❑ No.of Meters 0 iG Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: .11r)S(-c.(( iNa uric' Can, \/Q y i k.4 1 )hi-, e` (.i'1anciC_. 'fo A(c,.c-C1wM- Cv t-T" d e_c_291-c;G(C5 v) Completion of the followin&table may be waived by the Inspector of Wires. r No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total L Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ 1Vo.of Emergence 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 Tota 1 No.of Ranges No.of Air Cond. Tons No.of Alerting Devices "h No.of Waste Disposers eat Pump Number Tons KW o.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal p Local❑ Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.o ``ater No.of Devices or Equivalent No.of No.of Heaters ' Data Wiring: Signs Ballasts 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: 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 Z BOND 0 OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complet FIRM NAME: Re.,1 c, - ( (�.r E e j-u Q. w(`ry i LIC.NO.: f (/ J Licensee:.L- net 1Y"t C Lr1 e(t1� Signature ------LIC.NO.: (If applicable,enter "exempt",in the license number line.) Bus.Tel.No. 1)`5' 1 S-Oo36 Address: . T om;;_;f \M,,d Veck1 'br t,L; (r1'n'14,Jt , Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Dep ent 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ I i