No preview available
HomeMy WebLinkAboutBLDE-22-003521 Commonwealth of Official Use Only 1.� Massachusetts Permit No. BLDE-22-003521 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:12/26/2021 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 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 __T Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead ❑ Undgrd 0 Number of Feeders and Ampacity gNo.of Meters Location and Nature of Proposed Electrical Work: Exterior lighting 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 rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ton No.of Waste Disposers Heat Pump I Number I Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent KW No.of No.of Ballasts Data Wiring: Heaters Siens 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 I certify,under the pains and penalties of perjury,er ur that the information on this application is true and complete. FIRM NAME: Raul R Batallas Licensee: Raul R Batallas Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 20262 Address:49 BELMONT ST, FITCHBURG MA 014206218 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But my 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 /2(/.7"2„,„*, A t�ommonwea o Mjo4�vic�� �/r/ hu�elfd Official Use Only ` a'' eparlmenl oiire Jervice4 Permit No. �� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code NEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 901001 City or Town of: SMA VetefineattiTo 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) moo NT .R Owner or Tenant intronitldS Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes 0 Nan Purpose of Building ! (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ 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: 54// lt: io,. ett toy- lipthAq ikagiA) Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp. No.of Total p (Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting No.of Receptacle Outlets rnd. -rnd. Batte Units No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and No.of Ranges Initiatin, Devices No.of Air Cond. otal Tons No.of Alerting Devices `eat 'ump `um"'""er ons'-" r `o.o e onta ne • No.of Waste Disposers Totals: "" " ` `"" 'Detection/Alertin, Devices No.of Dishwashers Space/Area Heating KW Local❑ 'umcipa Na.of DryersConnection 0 Other ry HeatingAppliances K,��, curity ystems. PP No.of D `o.o Heaters KW rater }°•° `o.o Vices or E•uivalent Si ns Ballasts Data Wiring: No.of Devices or E•uivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommun cations i`irm : OTHER: No.of Devices or E•uivalent /�'90,OQ Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: / f � ._. (When required by municipal policy.) 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 ❑ I certify,under the ains and penalties of perjury, that the information on this application is true and co let e. FIRM NAME: t iC mP Licensee:— L �sl/�s • LIC.NO.: �_ (If applicable,enter "exem Signet p "in t cease number line. LIC.NO.: NY Address: O�S�73 Bus.Tel.No.: ' ,a/, la *Per M.G.L.c. 147,s. 57-61,security work requires DepartmentAlt.TeL No.: 'li OWNER'S INSURANCE WAIVER: I am aware that th cen Licensee doesl not c e�e the liability Lic.No. ��/ �� required by law. By ray signature below,I hereby waive this requirement. I am the(check one ■ owner ■ owner's Owner/Agent ty insurance coverage normally Signature _ r s • eat. Telephone No. PERMIT FEE: $