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HomeMy WebLinkAboutBLDE-21-006493 Commonwealth of Official Use Only n Massachusetts Permit No. BLDE-21-006493 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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 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 0 Undgrd 0 gNo.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: Install 26 CAT 5 cables. 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 INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons 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 KWNo.of Data Wiring: Signs Ballasts No.of Devices or Equivalent 26 No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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 I certify,under the pains andpenalties o (Specify:) f perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Address: Bus.Tel.No.: 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$115.00 ACommonwealth o j//taasact`fa Official Use Only B"` . ) c7 Permit No. /►'Pros spartmeni of glee Serviced I{ �' 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: ,f- c/ — 2 j City or Town ofr tr'rv-i U u T\ .Co J:\-• To the Inspector of Wires: By this application the undersigned gives notice of his or hdr intention to perform the electrical work described below. Location(Street&Number) /0 6 p ea v 7--e 2-S Owner or Tenant /V c',Il io.a Telephone No.-17:6-379_ Z,1 a? Owner's Address -5-'4-,.,,,-e Is this permit in conjunction with a building permit? Yes I ❑ No �'" (Check Appropriate Box) Purpose of Building too C 5',e;,•vt f C Utility Authorization No. Existing Service Amps / Volts Overhead 0 Und grd 0 No.of Meters New Service Amps / Volts Overhead 0 Undgrd�' ❑ No.of Meters Number of Feeders and Ampaety Location and Nature of Pro 1 posed Electrical Work: -,,,s rya 1, 2 6 C,y-j- Se c..-h It S/ T-e i.„1,.,,.-1---r ) Completion of the following.table may be waived by the I ctor of Wires. No.of Recessed Luminaires No.of Cell.-Sasp.(Paddle)Fans No.of Ttal Transformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting '�` No.of Receptacleend' grad. ❑ Battery Units No.of Oil Burners FIRE ALARMS iNo.of Zones No.of Switches No.of Gas Burners No.oTDetection and Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump!Number Tons )KW No.of Self-Contained Totals:I ._._._._..____. _._...._........1 Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal No.ofDryers Connection 0 Other Heating Appliances KW Security Systems:* No.of Water KW No.of No.of Devices or Equivalent Heaters No.of Data Wiring: Signs Ballasts No.of Devices or E uivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP q OTHER: No.of Devices or Equivalent O a 0 o Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: (When required by municipal policy.) _----i 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 I cer[ify,under the i nahies o ❑ (Specify:) fperjury,that the information on this application is true and complete. FIRM NAME: t d J w i C f-TZ. 45 y.r f t--' Licensee: 0 6��T LIC.NO.:7_____ /_ Signature .. LTC.NO.fiSC J'z S— W applicable,enter empt"in the license number line.) Address: 0 e >l-� ofC 4 /iBus.Tel.No.:ya/Y6/_66 ?7 *Per M.G.L.c. 147,s.57-61,security work requires Department of lic Safety"S"License: A Lic.No..: 0. 0 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 a:ent. Owner/Agent Signature Telephone No. PERMIT FEE:$ //4Th 0