The URL can be used to link to this page

Home My WebLink AboutBLDE-22-006283 .,,;:: Commonwealth of Official Use Only f I 11417, Massachusetts Permit No. BLDE-22-006283 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:5/2/2022 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) 1041 ROUTE 28 Owner or Tenant WG YARMOUTH REALTY LLC Telephone No. Owner's Address CIO WALGREENS ATTN: TAX DEPT, P 0 BOX 1159, DEERFIELD, IL 60015 Is this permit in conjunction with a building permit? Yes ❑ 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: Replacement roof top NC equipment. 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 If VA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ElNo.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 Initiating Devices No.of Ranges No.of Air Cond. 1 Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ 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 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 ❑ BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: Eric S Viveiros Licensee: Eric S Viveiros Signature LIC.NO.: 10753 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 192, WESTPORT MA 027900192 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 IkkECEIVED �/j// q�qmmonweal h o//Y/a�sacLie1fi Official Use Only C hraliiP5_ u Permit No. Z �v2i�3 c��L)eparttmenl o 5ire�ervice6 Occupancy and Fee Checked BUILDING ' vtENS?ARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) By. = CA t APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code EC),5 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: q/2 c 2 City or Town of: lc f hi By this application the undersigned gives notice ooffhi or er Inspector intention to perform heelectrical work described below. Location(Street&Number) I Q Li I 14 o - a Owner or Tenant c-4c iq r e en S Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate ppropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd L No.of Meters New Service Amps / Volts Overhead L Undgrd L No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: RepEce c 5 on oo14 p d/C aid- Completion 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 Tot No.of Ranges No.of Air Cond. I Tons No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of KW Heaters Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: LouAttach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Elec ' al Work: u (When required by municipal policy.) Z n Work to Start: I- „ ` L Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C ERAGE: 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 ❑ (Specify:) I certify,under the pains andpenalties op ) f perjury,that the information on this application is true and complete. FIRM NAME: Eric Viveiros Electrician LIC.NO.:10753-B Licensee: Eric Viveiros Signature j ��s (If applicable,enter "exempt"in the license number line.) LIC.NO.:10753-B Address: 16 Kyle Jacob Road Westport MA 02790 Bus.Tel.No.:774-929-0250 Tel.No *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt Lic.No..:774-319-5108 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 agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ SO