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Home My WebLink AboutBLDE-23-001466 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-001466 111 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:9/20/2022 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) 436A STATION AVE Owner or Tenant DUNKIN DONUTS Telephone No. Owner's Address PO BOX 459,WEST BARNSTABLE, MA 02668 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: Repairs to receptacle&cord due to fire. 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. grnd. Battery Units No.of Receptacle Outlets 1 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. TTotal No.of Alerting Devices n 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:* No.of Devices or Equivalent No.of Water 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 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Jeremy M Deaguiar Licensee: Jeremy M Deaguiar Signature LIC.NO.: 13659 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 19 AIKEN ST,FL 3,PAWTUCKET RI 028611615 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 . RECEIVED �, C� �M C23.14(9c °ffi se°nly • ,, Permit No. S P 7 2027 y 2. ,i sew CIL A `� BOARD OF FIRE PREVENTION REGULATIONS 1/ ] lea __ _l��1 ME T lea — APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK) i O.ct All work to be performed in accordance with the Massachusetts Electrical Code M 527 CMR 12.00 "'1(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: i" g c, -- " City or Town of: *ire" 'c' 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) Owner or Tenant ` \L (s >\ Telephone No. 5aSj-` I -I I4 I Owner's Address LA'3(p cA j 'r\ r�1/4)e Is this permit in conjunction wi building�permit? Yes El No [��Check Appropriate Box) Purpose of Building ee t�`t � ) Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Prorised Electrical Work: e V c Me\ I,eeKs - \ 'Cr e 6 V Co ktion of the followinktable nw be waived by the Invector of Wires. of Total W. No.of Recessed Luminaires No.of Cell (Paddle)Fans No.ns �• Transformers KVA C" KVA � No.of Lnminair+e Outlets No.of Hot Tubs Generators 't No.of Luminaires Swimming Pool Above ❑ In- ❑ Bate Units Lighting gt•nd. gird. Battery Units ` No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of Switches No.of Gas Burners No. 1Ho.of Detection and Initiating Devices v` No.of Ranges No.of Air Cond. Tuna No.of Alerting Devices Na.of Waste Heat Pump Number Tons KW No.of Self-Contained I�`w Detection/Ale .. Devices No.of Dishwashers Space/Area Heating KW Local 0 Mun 0 Other Cyoslnnsctton No.of Dryers HeatingAppliances SecNo.of Devices or Equivalent No.of Water , No.of No.of Data Wiring: HeatersSigns Berle No.of Devices or Eq uivalent dra Bathtubs No.of Motors Total HP 'Telecommunications r W hftg No.H yNo.of Devices or Equivalent OTHER: Attach additional detail if desireel or as required by the Inspector of Wires. Estimated Value of 'cal Work: trp(spn- (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C E: 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 ElOTHER 0 (Specify:) LQ ---307.. ZO i2' I ce,ilfr,under*Intend and, , of ,that titre information on this application is true and complete. FIRM NAME: VT`�,\ r_ v`Q'(_ ec C U C LIC.NO.: (3 LiSci B Licensee: F' V' ` w,.( Signature V LIC.NO.: (Ifappl' t 1" -� ,,�'. lute. ` Bus.TeL No.• Address X �N \ .c. !1 (e t 1 (L(t,Ait.TeL No.: *Per M.G.L.c. 147,s.57-61 'ty work requites Department of Public Safety"5"License: Lic.No. OWNER'S INSURANCE VER: 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. I PERMIT FEE:$ ( C 2l( 19;)