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Home My WebLink AboutBLDE-22-007177 s : Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-007177 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:6/13/2022 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) 517 ROUTE 28 Owner or Tenant Honey Dew Donuts Telephone No. Owner's Address 526 Route 28,West Yarmouth, MA 02673 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install security cameras. (HONEY DEW DONUTS) 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 grad. 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 Initiative Devices No.of Ranges No.of Air Cond. TotaloNo.of Alerting Devices 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:* 8 No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: Robert W Pierce Licensee: Robert W Pierce Signature LIC.NO.: 12359 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 12 FOSTER RD, E SANDWICH MA 025371040 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 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: $330.00 lUjIIia_i / iJl6'lt _. RECEIVED N 1 0 2Q22 `, ,081100a 0/7Maeeac Official Use Only ,.� tit . b ,, o/`.t Permit No.el.:7_ 7 (77 { - `c :I NG D E T Occupancy and Fee Checked / R�( �R PREVENTION REGULATIONS [Rev.1/07] (leave blank) CI 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 To the Inspector of Wires: IBy this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 8 2. IQ+ t3, ya,,,,�.0. 1c e. 3 Owner or Tenant c' y (5;p,...,-rtr y Telephone No. rf 71€61 8( -2 ' V Owner's Address Sc.,,,,.,e--- Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building G 0.114044.e..,4 4.-I Utility Authorization No. Existing Service Amps / Volts Overhead El Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd El No.of Meters 2 Number of Feeders and Ampadty L Location and Nature of Proposed Electrical Work: a_ 5 SC c- t_47 Cu vv ,raj Completion ofthefollowingtable may be waived by the Inspector of Wires. lb No.of Recessed Luminaires No.of Cell-Snap.(Paddle)Fans No.of Total Transformers KVA nNo.of Luminaire Outlets No.of Hot Tubs Generators KVA ..k' No.of LamioairesSwimming Pool Above ❑ In- ❑ No.of Emergency Ligating grnd. 11d. 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 IQ No.of Ranges No.oe Air Cond. Total No.of Alerting Devices No.of Waste Dern Heat Pump Number Tons KW No.of Self-Contained Totals: ' - ------------ Detection/Alertln Devices No.of Dishwashers Space/Area Heating KW Loral❑ Monnection unidp� 0 Other C No.of Dryers Heating Appliances KW Security Systems:* -INo.of Devices or Equivalent No.of Water , No.of No.of Data Wiring: Heaters gds Ballasts No.of 1 or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunica i ,us 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 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 0 (Specify:) I certi y,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: f3, ' J/c-,-e— . 2 -c_JV't e.t4. I� LIC.NO.: t�-3 S..? -Y3 Licensee: 13 o b 1�rr e. Signature 7v 9:7,.„-- LIC.N .: 5a W-0- (If & (If applicable,enter"exempt"in the license number line.) 'A^� Bus.TeL No. 21- 6 Address: 12- Fos+-t✓ e..�! S�VIAtJ►LLa )4Ip az53 Alt.TeLNo.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:5.3 : '72W/_ 2a2- 34F! * ., -0V19ra e•or PrOtirssoorial LiesgFure 4•'•••` Sec urit *41 i C is,License _ J .: ROBEFRr WC Pr A/ J 1 On a7-7 ROBEErR W.PI- 0 M " Commissioner -. aI • c. i I r