HomeMy WebLinkAboutBLDE-21-006486 Commonwealth of Official Use Only
filth Massachusetts Permit No. BLDE-21-006486
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:5/10/2021
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform 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 W1 B, 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 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: Relocate equipment as needed per attached.
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 0 Municipal 0 Other:
Connection
No.of Dryers Heating Appliances KW Securi 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. 4 I�✓ n 4Z y7 ?31
CHECK ONE:INSURANCE ❑ BOND 0 OTHER 0 (Specify:) G- �
I certify,under the pains and penalties ofperjury,that the information on this application is true and complete.
FIRM NAME: Neil G Berthiaume
Licensee: Neil G Berthiaume Signature LIC.NO.: 17292
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:21 WILBRAHAM ST,UNIT 11A,PALMER MA 010699672 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
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Occupancy and Fee Checked
:,. ,( 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(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 5/4/21
City or Town of: S Yarmouth To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 1060 Route 28
Owner or Tenant McDonalds Telephone No. 508-394-2303
Owner's Address Same
Is this permit in conjunction with a building permit? Yes IZ No
❑ (Check Appropriate Box)
Purpose of Building Commercial Utility Authorization No.
Existing Service Amps / Volts Overhead 0 Undgrd
-- g 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: Relocate existing cook center panel,wire new front counter,
reroute wiring for relocated equipment behind front counter
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Cell: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 INo.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Tonsl No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained
Totals: I Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal
Connection ❑ Other
No.of Dryers Heating Appliances Kam, Security Systems:*
No.of Water No.of No.of Devices or Equivalent
Heaters KWNo,of Data Wiring:
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: 5/24/2021 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 ® BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties o
p jperjury,that the information on this application is true and complete.
FIRM NAME: NBE Electrical Contractors, Inc. LIC.NO.: Al7292
Licensee: Neil Berthiaume Signature —77;/ 0/--- of„,a, LIC.NO.: E29437
(If applicable,enter"exempt"in the license number line.)
Address: 21 Wilbraham St 11A Palmer, MA. 01069 Bus.Tel.No.: (413)283-8800
Tel.No.: 237-4155
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lic.No. (413)SS-001960
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)❑owner ❑owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE:$100.- I