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HomeMy WebLinkAboutBlde-20-000009 ECommonwealth of Official Use Only
Massachusetts Permit No. BLDE-20-000009
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:7/1/2019
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below.
Location(Street&Number) 1060 ROUTE 28
Owner or Tenant MCDONALDS CORP Telephone No.
Owner's Address MCBEE ENTERPRISES, 50 OLIVER STREET STE W1B, NORTH EASTON, MA 02356
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 ❑ 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: Wiring for menu boards(MCDONALD'S RESTAURANT)
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
Ali.
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
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/Alertine 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: Drake T Elliott
Licensee: Drake T Elliott Signature LIC.NO.: 21312
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 196 HAYDEN RD, GROTON MA 014502072 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: $160.00
Commonwealth.oil!/tas3acluuaeftd Official Use Only
cc��yr�,, Permit No.
f rIB .1Jeparlmonl of ire-Yonne' ea
i( ? Occupancy and Fee Checked
_, � .7 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071
(leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR I2.(la
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 6/26/2019
City or Town of: SOUTH YARMOUTH To the Inspector of Wires:
is application the undersigned gives notice of his or her intention to perform the electrical work described below.
t 1 hoc tion(Street& Number) 1060 RT 28
N w er or Tenant MCBEE,MARK Telephone No. 5082302190
1060 RT 28, SOUTH YARMOUTH,MA 02664
r i AOw er's Address
— cc ! t is permit in conjunction with a building permit? Yes ✓r Non (Check Appropriate Box)
L uit ose of Building Restaurant Utility Authorization No.
, z' t
-gxi ing Service Amps I Volts Overheads Undgrd_ No.of Meters
e» Service Amps / Volts Overhead Undgrd No.of Meters
Ru ber of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: OUTDOORS - INSTALL CIRCUITS AND LOW VOLTAGE
WIRING FOR OUTDOOR MENU BOARDS (TRENCH INSPECTION NEEDED).
Completion of the followin, table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Tot
al Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above I In- No.of Emergency Lighting
grnd. I grnd. . Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners -No. In Detectionand
Initiatinngg Devices
No.of Ranges No.of Air Cond. To sl No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices
Municipal I I
No.of Dishwashers Space/Area Heating KW Local (ConnectionLi
Other u
No.of Dryers Heating Appliances KW security S stems:
t'Y No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaters KW Signs 3 Ballasts No.of Devices or Equivalent
No.H dromassa a Bathtubs No.of Motors Total HP TelecommunicationsofDeir Equivalent
ing:
Y g No.of Devices or Equivalent
OTHER:
$5,000 Attach additional detail if desired,or as required hr the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: 6/25/2019 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 cover e is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND rl OTHER[Specify:)
I certify,under the pains and lties of p ,that the rtnation on this application is true and complete.
FIRM NAME: Drake T Elliott LIC, NO.: 21312A
Licensee: Drake T Elliott Signature f,/eg, ‘C) LIC.NO.:
(If applicable,enter "exen t"in the&cense number line.) Bus.Tel.No.: 774-823-4531
Address: 196 Hayden Road, Groton,MA 01540 Alt.Tel.No.: 774-437-9072
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilit ranee cage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one owner _owner's agent.
Owner/Agent PERMIT FEE: $ 160.00
Signature Telephone No.