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Home My WebLink AboutE-19-2319 Commonwealth of Official Use Only i a Massachusetts Permit No. BLDE-19-002319 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.1/071 . 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:10/18/2018 City or Town of: YARMOUTH To the inspector q Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 474 STATION AVE UNIT 1 Owner or Tenant LINEAR RETAIL YARMOUTH#3 LLC Telephone No. Owner's Address 1 BURLINGTON WOODS, BURLINGTON, MA 01803 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install additional devices.(Citizens Bank) 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. grad. 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:* 3 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: Walter Reznikiewicz Licensee: Walter Reznikiewicz Signature . LIC.NO.: 401 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: - Address:26 RAYMOND AVE,HOLYOKE MA 010401820 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:$115.00 • ) '...► • Print Form Commonwealth o/ qadiach usettd Official Use Only � �t cy �7 Permit No. L7 —2-/ I cli C d gI a 2Permit of ire Serviced 113 t-Er Occupancy and Fee Checked t+ 76•* 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 C), 27 CMR 12.00 �' (PLEASE PRINT IN INK OR TYPLL�I/N�FO TION) ' Date:Jl3 ,y t-.57v6/-04 LCity or Town of: c N Th 4, ,-h To the Inspector of Wires: p By this application the undersigned gives notice of is or her intention to perform the electrical work described below. 1 Location(Street&Number)/, t/7471 3-�/I.hpn /C- l/ Owner or Tenant /t•! ?�� s c el-in t Telephone No. Owner's Address d� C Is this permit in conjunction with'a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. 7 ' Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity // /- Location and Nature of Proposed Electrical Work: yid57h Ill /7 4, _�T' a.e.f5' .See(e,i rin'il o Completion of the followingtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceif:Susp.(Paddle)Fans Traa Toof TVA nsformers EVA No.of Luminaire Outlets No.of Hot Tubs Generators EVA 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 I; ' No.of Switches No.of Gas Burners No.of Detection and w Initiating Devices Total eero No.of Ranges No.of Air Cond. Tons No.of Alerting Devices C.4 . ¢ ` No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 0DO w Totals: Detection/Alerting Devices r+ 0 No.of Dishwashers Space/Area Heating ICW Local❑ Municipal ❑ Other, t7 i Connection :U 2._1 No.of Dryers Heating Appliances ElY Security Systems:* �. No.of Devices or Equivalent 4,13 No.of Water No.of No.of I Heaters KW Ballasts Data Wiring: . .,,� Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: iflAttach additional detail if desire4 or as required by the Inspector of Wires. Estimated Value of a tcal Work: a 13 (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 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:Johnson Controls Security Solutions LLC LIC.NO.:401 C Licensee: Walter Reznikiewicz Signature tidy v tatiirc LIC.No.:401 C . (Ifapplicable,enter "exempt"in the license number line) Tel.No.•781 680 0412 Address: 1400 Providence Highway Norwood Ma. 02062 0 Alt.Tel.No.:413 750 0200 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. 002272 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)0 owner 0 owner's agent. Owner/Agent PERMIT FEE: $ f1 Signature Telephone No.