HomeMy WebLinkAboutBLDE-22-005698 Cottage #3 Commonwealth of Official Use Only
.ten441 Massachusetts Permit No. BLDE-22-005698
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
IRev.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:4/6/2022
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) 28 SOUTH SHORE DR
Owner or Tenant RED JACKET BEACH LTD PARTNERSHIP Telephone No.
Owner's Address 20 NORTH MAIN ST, SOUTH YARMOUTH, MA 02664-3150
Is this permit in conjunction with a building permit? Yes 0 No ❑ (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 smoke detectors(COTTAGE#3)
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
Initiatine Devices
No.of Ranges No.of Air Cond. Ton l No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained 2
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: 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
S4 Comm:wowiii elc7yI7� #O�;r use __
Y = Jiro Snvicw Permit No. l'�2�-"5`c-DC'( i
�` Checked
BOARD OF FIRE PREVENTION REGULATIONS `yandF«dub)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Masseclanetts Electrical Code(MEC),527 ChM 1200
Id
C (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: `f( (era
City or Town of: yes flYlO To the Inspector of Wires:
f By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
v Loads'(Street&Number)f� _I S Shore I I
`1 Owner or Tenant K eel Tx, �GV e,+ 1 Jecic.1,-). Rc So r-- Telephone No.
Owner's Address
C1 ' Is this permit in coajoctieo with a Miaow permit? Yes 0 No ❑ (Cheek Appropriate Box)
Purpose of Betiding Utility Authorization No.
4) ; Ex6Wg Service_ Amps I Volts Overload El Undg d 0 No.of Meters
New Service _ Asps / Vohs Overhead❑ Undgrd❑ No.sot-Meters
p ' Number of Feeders and Ampmity
Location and Nature of Proposed Electrical Work &}{age ."4 Qua o (2)is e clef c c+cts
.. i w,+h sniaP.e%o t1OMbf cthl+s 'ZPgIac( Ci rc.ss.I breaker#o an arc tit. ilpe
Completion ofueFollowi g-�NNkdkoeuo[ '1'
asJ be,adwdby de IieeadofWbrs.
t_it No.of Recessed Luminaires No.of Cat.-Sap.(Paddle)Fans Transformers KVA
4 No.of Lumioke Oathtts No.of Bet Tabs Generation KVA
A I Above on In- 1-1 Ito.et Emergency upping
No.of L..daaires Swimming Peal gm, ❑ gad. ❑ Battery Oaks
. Z.4 , No.of Receptacle Outlets No.of OF Burners FIRE ALARMS No.of Zs.a
No.of Switches No.of Gas Boners
z- lsitl•tia[Devices
Ili ' No.of Ra.Bes No:of Air Cond. T� No.of Alerting Devices
ed
No.of WauteDispse s Heat
Number IToa KWI Devices
No.of Dishwashers SpaoelArea Heating KW Laud 0 C ❑Other
No..f Dryers Hem APl+Raaees Kw Security
Ns.d er Ee.lvalmt
WVWiaer oTr-a— No.of Data Wirier
KW
Heaters —NW— Babas No.atDevices
alat
Tdeumm. m gllL1.yy
No.Hydsemamage Bathtubs No.of Motors Total HP No,of Devises or EY.ly lent
OTHER: `
Attach addhiond detail Ideabad or as repined by the leupo.or of Wks.
Estimated value of Electrical Work: _ (When requited by moicipel policy.)
Work to Start Inspections to be requested in aocadance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work nay tame alms
the licensee provides proof of liability insurance including"completed operation"covaa@e or its awl 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❑ (Specify:)
I eertitt,ander the pains and penalties ofpAJa/p�,that the htfa..tadea ea this appscrdau is kite ad c.a iuteFIRMNAME: FLI(df 1fC r(C.. l Are\f my LK.NO.: AlIV (ff
Licensee: Lane:° Theleg/lpm e ) LIC.NO.:
(ffappllaable.aver"craws':in the license line.) Bea Td.No.:SIR-1 l C-Co 30
Addres: II In l Ill,d Tech r \"1. 7`'r{rno LA t 1 Ale.TeL No.: _
'Per M.E.L.i c.147,s.57-61,security work requires Department of Public Safety"S"Erase: Lie.No.
OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability imwrace coverage normally
required by law.By my signature below,I hereby waive this relent.I am the(check one)❑owner 0 owner's meat
Owaer/re Telepwee No. I PERMIT FEE:$ So.06