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Home My WebLink AboutBLDE-23-000576 Old Block Busters Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-000576 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:8/4/2022 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) 1070&1074 ROUTE 28 Owner or Tenant DAVENPORT DEWITT TR Telephone No. Owner's Address 20 NORTH MAIN ST, SOUTH YARMOUTH, MA 02664 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: Install additional receptacles, telepoles, repair lighting, Replace exit signs, & EBU's(OLD BLOCKBUSTER AREA) 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. rnd. 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 Tons 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 ❑ Other: Connection No.of Dryers Heating Appliances KW ▪Security Systems:* N• o.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: LANCE A MACENERNEY Licensee: Lance A Macenerney Signature LIC.NO.: 11149 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 126A MID TECH DR,W YARMOUTH MA 026732560 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $300.00 Commonwaalfh 7 rr/addacb .lid Official Use Only r ecms7/ `�- Permit No.y�1 5 7 V `l dpartmsnl a/..flea—cervical .� I ,• Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.I/07] (leave blank) j APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC).527 CMR 12.00 cl (PLEASE PRINT IN INK OR TYP ALL INFORMATION) Date: a a L City or Town of: t +{h To the Inspector of Wires: V E Q •—,b By this application the undersigned gives notice of his or her intention to perform the electrical work describ low. Location(Street&Number) Q jpk AUG 03 2022 Owner or Tenant Telephone No b. Owner's Address a BUILDING DEPARTMENT d Is this permit in conjunction with a buihBng permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building M fri ea,Q Utility Authorization No. Existing Service Amps / Volta Overhead❑ Undgrd❑ No.of Meters a �_ New Service Amps / Volts Overhead E] Undgrd❑ No.of Meters Number of Feeders and Ampacity 1 Location and Nature of Proposed Electrical Work: .!`rat"`out'efs/--fell o 1t'S (P pal( 1 lc(Irks QCf)i0.CC. e,-c 4- ab C' IghtS 5o'LQC1 �(SOr S�.tC}. nCompletion of the follow) may be waived by the/npector of Wires. titNo.of Recessed Luminaires No.of Cell.-Sup.(Paddle)Fans No.of Total C Transformers KVA Cl No.of Luminaire Outlets No.of Hot Tubs Generators KVA a # No.of Luminaires SwimmingPool Above ❑ In- ❑'No.of Emergency Lighting trod gruel- Battery Units J No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 7. No.of Switches No.of Gas Burner No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. TotalNo.of Alerting Devices Tons No.of WasteDisposers Hest Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerthts Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other Connection No.of Dryers Heating AppliancesKW Securityy stems:* Naof Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent s Wiring: No.Hydromassage Bathtubs No.of Motors Total HP Tei No.of Devices oor 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 ❑ OTHER 0 (Specify:) I cart'',under the pains and penalties of perjury,that the information on this application is true and complete. RM FI NAME: IuJ Ie( l a l C C()IV\ea ly LIC.NO.: A i 11'9 Licensee: i yt F �'� ( Signature .0---- LIC.NO.: (If applicable,enter"exempt"in the lices, nwn r line.) r i- Bus.Tel No: Address: (7ieA CYN,ciTGc..k or (Al. (mC5kY\ Alt.TeLNo.: 'Per M.G. .c.147,s.57-61,security work requires t 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 PERMIT FEE:$ 3C0 C) SignaturenatureTelephone No.