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Home My WebLink AboutBLDE-19-001949 00 0 v Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-00194 •9 OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.l/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:10/2/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives no ice o is or her in en ton o per orm a ec a o cribed below. Location(Street&Number) 976 ROUTE 28 Owner or Tenant YARMOUTH COMPASS LLC Telephone No. Owner's Address %CVS PHARMACY INC ACCTING DEPT(#735), 1 CVS DR,WOONSOCKET,RI 02895 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: Add receptacles,exit sign,&shelf lighting. Completion of the following table may be waived by the Inspector of Wires. I No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of Total Transformers KVA 'No.of Luminaire Outlets 1 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ET In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 10 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 0 Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Stens 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: 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 ❑ BOND 0 OTHER 0 (Specify:) Q �8 - 1�q 6 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. 1 8( 'l 1 511 FIRM NAME: David M Fagan Licensee: David M Fagan Signature LIC.NO.: 21578 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 17 GREENWOOD AVE.WOBURN MA 018014207 Mt.TeL No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"5"License: OWNER'S INSURANCE WAIVER:I ant aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$80.00 aa 1013021B t€ _- r' .1 , ~ £ma • i( I hSo�i�-n ct. gn %_ ammonava&e f Masse as Official Use°ru W. _ meq - Q ea c PermitNo. \ .-IIl_ 1JePa'fmanf of..tin Services `W � Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev. 1/071 (leave blank) APPLICATION FOR1PERMiT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ) O — 2^ /i' City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to=the the ecai work described below. . Location(Street&Number) ?-it. • /go sea •s•--b _ Owner or Tenant C.UP P1xsUeac11 Telephone No. Owner's Address 1 Is this permit in conjunction with a building permit? Vat No 0 (Check Appropriate Box) Cr-- _ Purpose of Building CO Mff12r f „aL Utility Authorization No. _ -Er ting Service Amps / Volts Overhead Q Undgrd Q No.of Meters jyj! m tie Service Amps / Volts Overhead 0 Undgrd d❑ No.of Meters N iVamber of Feeders and Ampacity 1 c'2 1 oCation and Nature of Proposed Electrical Work: (7_0_1 d ts,c$'a 3 oU ( ..' Q NnS)b10„1, .4...-A-,S‘\ CI; �• VU ! t4# h-Ur ne_t t C inla,r-/ �1e Ge-t_ 1 cXc‘ st Sl^') W 7,-.e... 1 Siu.f.f% f0+• ,t. n Completion of the following table maybe waived by the Inspector of Wires. U i , O iNot 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 k.mergency Lighting grad- In-d. 0 Battery Units No.of Receptacle Outlets I/ 0 No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners • No.of Detection and Initiating Devices - No.of Ranges No.of Air Cond. Ton No.of Alerting Devices • No.of Waste Disposers Heat Pump Number Tons KW No.of Self Contained Totals:I I I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:` No.of Water No.of Devices or Equivalent No.of No.of Data Wiring Heaters 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 Vdesired or as required by the Inspector of Wires. Estimated Value of Electrical World .3S �t) (When required by municipal policy.) Work to Start: /o-Z '/ i•-' 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: INSURAblet-C1 BOND 0 OTHER 0 (Specify:) f cernfy, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: a5t3 &Lc-F.r.?C.r_\ Sary:co. 'fn. LIC.NO.: a iris-A Licensee: Lin cc_ sca 4 a r` Signature e.. Tel. NO.: •Z6 j E- (If applicable,enter"exempt"in the lig num er line) Bus.Tel.No.: Address. V` 0 Tao k S''[ �Ut�w +• fr(4 Che t-- ��'��$l^ J 'Per M.G.L.c. 147,s.57-61,security work requires Department of Public SafetyAlt.Tel.No.:'i 3-t 63 t/ "S"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally itrequired by law. By my signature below,i hereby waive this requirement. i am the(check one)❑owner ❑owner's agent t Owner/Agent G Li I/. 1 Signature Telephone No. I PERMIT FEE: $ O