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Home My WebLink AboutBLDE-19-006213 Dollar Tree Commonwealth of Official Use Only .� Massachusetts Permit No. SLOE-19-006213 4 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:5/3/2019 City or Town of: YARMOUTH To the I pector of Wires: By this application the undersigned gives notice of his or her intention to pert rm( 4 the electrical work describ low. , Location(Street&Number) 517 ROUTE 28 1l ` t L> NI ,�-1.I41L^__n z-E-e) Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Add two house panels off existing meter. 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 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:* 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: TIMOTHY W MCINTYRE Licensee: Timothy W Mcintyre Signature LIC.NO.: 31437 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 2428,TEATICKET MA 025362428 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:$100.00 V\aS CI1 (� L Ca-611 j 4(tIlq d 1 (8(6q l CommoruveaCth oil Ma6dachtt :' Official Use Only —_- - Permit No. �%C eL - 1 3 =, -- •i =.�_ - sarvi�s -=f ''' Occupancy and Fee Checked -,,. ,,•. BOARD OF FIRE PREVENTION REGULATIONS tRev. 1/07] (leave 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: City or Town of: YARMOUTH �~ectorof Wires: By this application the pndersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 372 ,j ,4. �eR E.e/e t,' X'm'o ?Z . .#`c5-. Owner or Tenant /111/c/e i> GL-C.- Telephone No. Owner's Address /?C7. bak .2/422 Is this permit in conjunction with a building permit? Yes 4------- No ❑ (Check Appropriate Box) Purpose of Building Cc eec.r4/ ge ya STcy►t. Utility Authorization No. Existing Service /04 Amps /zo/ ZGO Volts Overhead ❑ Undgrd t;i' ❑ No.of Meters New Service /GD Amps / I?U. Volts Overhead❑ Undgrd `------- No.of Meters / Number of Feeders and Ampacity ' 2 Alm. Location and Nature of Proposed Electrical Work: 6AW ,2_. j.7Gt"lS E /p vte Is offm eX/.S7%•7. 4.(17-Ci- Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Busy.(Paddle)Fans No.of Total Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting - ernd. crud. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches No.of Gas Burners No.of Detection and • Initiating Devices Total No.of Ranges Na.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump 1 Number Tons KW No.of Self-Contained Totals: I ( �- Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Q Municipal Connection ❑ er No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent No. of Heaters KW Data Wiring:Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent ; Attach additional detail yrdesireci;or as required by the Inspector of Wires. Estimated Value of Electrical Worl (When required by municipal policy.) Work to Start: S_a _/S 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 ErrOND ❑ OTHER 0 (Specify:) Pe fy:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete.. FIRM NAME: �� !'Ilc- Licensee: /%sMelix' i it Zc,i_y,r Signature LIC.NO.:(If applicable,enter "exempt in the license rrfi her line. .� !� --3-�`�' Address ?v��y .?v�13 � ie��,7~ Bus.Tel.No.: 77v- �6 ,26 �'q P'�JZ Alt.Tel.No.: `Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. -- OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement 1 am the(check one 0 owner ❑owner's a eat. Owner/Agent Signature Telephone No. PERMIT FEE: $