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Home My WebLink AboutE-19-2480 Commonwealth ofM 'Oki" Official Use Only Massachusetts Permit No. BLDE-19-002460 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.l/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:10/26/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pert orm the electrical work described below. Location(Street&Number) 908&928 ROUTE 28 Owner or Tenant BASS RIVER REALTY LLC Telephone No. Owner's Address 113 PLEASANT ST,SOUTH YARMOUTH,MA 02664 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install receptacle for ATM machine.(ROUTE 28 DINER) 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 ln- ❑ No.of Emergency Lighting grnd. grnd. Batten 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 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 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 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: Daniel H Levesque Licensee: Daniel H Levesque Signature LIC.NO.: 18145 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:4 WINSOME RD,S YARMOUTH MA 026641028 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 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 0,j ( w!29fe 4 a„„,;,,,,,,,,at7h 01 sr/amac�+asrlG Use Only —F"' c7 cc77"" pp Z /� 2 admen!of„Yire Sendai Permit No: �Q �� O BOARD OF FIRE PREVENTION REGULATIONS Occupancy a7611 ee Checked _ S SJl r. I/07] e 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:/cbs)1 J City or Town of: YARMOUTH To the Inspector of Wirer . By this application the undersigned gives notice of his or her intention to perform the electrical work described below. • Location(Street&Number),, ff Rig' 29 Q Owner or Tenant /j/£ Telephone No.f�-39� ;7 Z Owner's Address gyri- �i gam' S .ymgv7eo . aa o Is this permit in conjunction with a building permit? igi Yes 0 No Q (Check Appropriate Box) c� "lug Purpose of Building /?��jj jy y� Utility Authorization No. Lit TCM o Existing Service a2pp Amps j.2a /„io PJ0 Volts Overhead oa Und 4 t— t7 gtd❑ No.of Meters ! Q o ew Service Amps / Volts Overhead❑ Undg • rd 0 No.of Meters , ce L --Jen �m m amber of Feeders and Ampadty tion and Nature of Proposed Electrical Work: �; i , a 'Xfr 7-.!) OotriciSR ntrogg ATm'i 77i 'O 0?ExiSS)Nff o'cc, Ci2[.ver OH Sg S vi ID1=O fes SIM.,ie%'i f Fan e/2 Completion of the followin_ table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeH.-Snsp.(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 trmergency Lighting arnd. grnd. 0 Battery Units No.of Receptacle Outlets No.of OH Burners • FIRE ALARMS IND.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 I Number ITons I KW No.of Self-Contained Totals: 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 No,of Devices or Equivalent Heaters No.of Data Wiring: — Si• $ Ballasts No.of Devices or E.uivalent No.Hydromassage Bathtubs No.of Motors Total HP [Telecommunications inng: I No.of Devices or Equivalent OTHER: #,--• Attach additional detail if derired or as required by the Inspector of Wires. Estimated Value of Electrical Worly 5a> (When required by municipal policy.) Work to Start: /p lis j- Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C6V GE: 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 terrify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRMNAME:74JL)W B. Lzvtat .D43533- 12411i W. f filar: LIC.NO.:C ) r Licensee: (If applicable,enter"exempt"in the license number line) Signs re LW.NO.: 1=� Address: Bus.Tel No.: J Per M.G.L.c. 147,s.57-61,security work requires D SafetyAIC Tei.No.: Department of Public "S"License: Te.No. ---------- - OWNER'S INSURANCE WAIVER I am aware that the Licensee doer nor have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. 1 Owner/Agent1 j Signature Telephone No. I PERMIT FEE: $