HomeMy WebLinkAboutBLDE-22-004676 Commonwealth of Official Use Only
fE _
gMassachusetts Permit No. BLDE-22-004676
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.l/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:2/24/2022
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to pe�the electrical workt scribed below.
Location(Street&Number) 517 ROUTE 28 \`fHh�t f^-tAD
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 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: Removal of unused wiring(525 Rt 28)
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
Initiatine Devices
No.of Ranges No.of Air Cond. Total No.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 ❑ 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 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: Michael J Maguire
Licensee: Michael J Maguire Signature LIC.NO.: 25035
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 148 AUDREYS LN, MARSTONS MLS MA 026481631 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: $80.00
C.4,,, 6r , 0
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Commonwealth of Massachusetts Official Use Only
14-A1,-.= Permit No. L-------7-77----`I`/ /6,7` ,
-=*:= ,, Department of Fire Services
.--,, Occupancy and Fee Checked
R ' 7.0' I ��AN ••F FIRE PREVENTION REGULATIONS [Rev. 11/99] (leave blank)
-FEB 2 3 2022A ICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
1 irk to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
LEASE PRINT . OR TYPE ALL INFORMATION) Date: p� 3 c c 2 -
BUILDINGikRT NT
_�i> or �9 I. /
�Y 0/4�Qzit To the Inspector of Wires:
pp'cation t u e un•ersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) J S / ,2 5 1(../}--,-;,--,.,o„-,,/./ a,<,---9_
Owner or Tenant "/„A,..,/ , g 04, Telephone No.S'a$ 776 .2/r
Owner's Address f O j?, x- - -/..Z ¶-" // ri,, /9�7 on_ /
Is this permit in conjunction with a building permit? Yes L / No El Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service? Amps /oZG/ .C'o Volts Overhead❑ Undgrd[-----No.of Meters
New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
Number of Feeders and Ampacity '
Location and N hire of Proposed Electrical Work: 'Pie r'IOU`r a/147,/r„ -, p?o r/6 -//},'
L/S c-- C`
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Lighting Outlets No.of Hot Tubs Generators KVA
No.of Lighting Fixtures Swimming pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grad. 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. Too sll No.of Alerting Devices
No.of Waste Disposers Heat ooPt P Number Tons KW No.of Self-Contained
Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local ❑ ConneMunicction al 0 Other
No.of Dryers Heating Appliances KW Security Systems:
ry No.of Devices or Equivalent
No.of WaterKW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total U1 Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
Attach additional detail ifdesired,or as required by the Inspector of Wires.
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 el BOND 0 OTHER 0 (Specify) 171-
Date)
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start;.'..,, Cr —.2--Inspections to be requested in accordance with MEC Rule 10,and upon completion.
I certify,under the airs and/ penalties of pe�ry,that the information on this application is true and complete.
FIRM NAME:/ /v h a / Ji'll7 z'i/'P , LIC.NO.: _
Licensee:,,i4.e/c),a JJ� &(r e- Signature i % � e- LIC.NO.: s b
(If applicable,enter"exem t"in the', cense ber line.) /j Bus.Tel No.: 5�`6 �/
Address:/��a-Gd i,..,,)5 L) /4,1/09,//l'./1/ c,�‘ e/5 Alt.Tel.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 Telephone No. I PERMIT FEE: $ I
Signature
Elliott, Ken
Subject: Honey Dew Donuts 517 RTE 28
Location: Microsoft Teams Meeting
Start: Tue 6/14/2022 9:00 AM
End: Tue 6/14/2022 3:00 PM
Show Time As: Tentative
Recurrence: (none)
Meeting Status: Not yet responded
Organizer: Fallon, Rosa
Required Attendees: Inkley, Brad; DiBenedetto, Mark; Elliott, Ken; Huck, Kevin; Bearse, Matt; Renaud, Philip;
Riker,Adam
The Building Department is �•� � • to conduct a final for occupancy inspection „ �'� �'
Yarmouth, Ma 0267 ` Tony Gionfriddo 774-801-8178 is the contract person. We would like for
you to attend. Please notify me regarding your inspection results.
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