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Home My WebLink AboutBLDE-19-005264 Commonwealth of Official Use only i i a�. , . .zeiri7 Massachusetts Permit No. BLDE 19-005264 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:3/20/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perto the electrical work described below. Location(Street&Number) 142 ROUTE 6A ( A 2�e3 Owner or Tenant 461ragesakinlabliKiffr Telephone No. �J dr, Owner's Address , `o �� Is this permit in conjunction with a building permit? Yes 0 No 0 (( , ; ) J�/ Purpose of Building Utility Authorization Ne. Existing Service Amps Volts Overhead 0 Undgrd 0 o.OMeters New Service 60 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install service to pole mounted equipment on pole#1/29 142 Route 6A, Yar. Pt. 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 0 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 Initiating Devices No.of Ranges No.of Air Cond. 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 ❑ 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 Data Wiring: Heaters Signs Ballasts 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 of perjury,that the information on this application is true and complete. FIRM NAME: John J Borkowski Licensee: John J Borkowski Signature LIC.NO.: 15694 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:98 HILMA ST, QUINCY MA 021712744 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 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 OR_ Lilitli9 ceg, c& /13( a SCommonwealth o/!//aaeaclutsetlo Official Use Only_ f(I. ,�. c� Permit No. l,�Y `'"*' t • �spae�in.nE o�,tirr Serviced and Fee Checked J BOARD OF FIRE PREVENTION REGULATIONS [Rev. (leave blank) t APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 0 (PLEASE PRINT IN INK OR TYPE INFORMATION) Date: 3�-// —/ zJ City or Town of: ! - ` fz.#- To the Inspector of Wires: By this application the undersigned ves notice of his or her intention to perform the electrical work described below. ) Location(Street&Number) /4/Z. RTC' /9 —Cq /C/ir/6-4- /16-4 y Owner o en , `//--A.,/ZL,"..../ 1&)/4..z./c,rJ Telephone No. %,- y 774.E k.l Owner's Address //e" /—LA4✓4/ LJ ;?A , iti "SY-,e.zc /"90 Z;zr// Is this permit in conjunction with a buiid�permit? Yes O. No ❑ (Check Appropriate Box) C Purpose of Building /72 G/17 7 d le Utility Authorization No. /, �S Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service (p 0 Amps /IC i2 44'O Volts Overhead tg Undgrd 0 No.of Meters j Number of Feeders and Ampadty 3 —:#.?r/,I✓, , 0 my, :.SGY.u/ce Location and Nature of Proposed Electrical Work: �',v./y7oce.„ /07to-7-e''z___/ .d/fee,,,,vc*�' 1 /'i s. 4ae'/ .,eal V's) 7..le_ Btvee_„- tAO i'/�. ,-e, / k"a/�e2 pot.,67 go, /-�tJ t/Completion of followini_tabl aw be waived by the lnvecfor of Wires. Total t.l3 No.of Recessed Luminaires No.of Cell.-Sus .(Paddle)Fans No.ofKVA p Transformers KVA Q No.of Luminaire Outlets No.of Hot Tubs Generators KVA a Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool d. ❑ d. ❑ Butte Units '^1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and F No.of Switches No.of Gas Burners Initiating Devices 14,1 No.of Ranges No.of Air Cond. Tons No.of Alerting Devices Real Pump Number Tons __KW _ No.of Self-Contained No.of Waste •Disposers Totals: Detection/AlertinLDevices No.of Dishwashers Space/Area Heating KW Local❑ Municipal 0 Other Connection No.of Dryers Heating Appliances KW gecuritySysteins:* '�' No.of Devices or Equivalent _ No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent _ No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsofDevices g: No.of Devices or Emily t OTHER: 3— 2,o n''f, c ,t t t'r r r / ef.t, , 4/7zrwii//1- , ,° G/'el.'•'.-✓ it Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: /..C U ' `y (When required by municipal policy.) Work to Start: 3 /1-/1 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 cEprage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE a BOND 0 OTHER 0 (Specify:) I certify,under the pains and pa of petjary,that the information on application is true and complete. FIRM NAME:,L1 i)& /as4 e—/r'cAIca/ f.--r -;00 LIC.NO.: ,//Z2r Licensee: coir"J ' 0itie o,rAI Signature ✓car-- . LIC.NO.:4/Sf f y Of applicable.enter"exempt"in the license number line.] 4v Address: te:2 ,2R.eJ!d C^-T7 / i�< (j tr,..,c /12 %I Gr�/�, Bus.Tel.No.:7.�/�S�r-U �f0 Alt.TeL No.:l./7-l-"ram F/13 *Per M.G. 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ • I'IU:PARED BY: SITE NAME: (., YARMOUTH_SC2O_MA LOCATION CODE: N EX I US 388936 w Ln SITE ADDRESS: Au OFFICE: LIZ xesT►o�MA 01999 UTILITY POLE NO.: 1-29 -a I(972)755-1552 142 ROUTE 6A - OLD KINGS HIGHWAY YARMOUTH, MA 02675 Z w * CHENMY %& STRUCT(1RAL g Cm, > rI rd r # 1/30/2018 f { i I '� THIS DOCUMENT IS THE DESIGN - - - » PROPOSED LESSEE ANTENNA'6: »' I PROPERTY AND COPYRIGHT OF NEXIUS AND FOR THE E%CLUSNE USE BY THE -+ RRH MOUNTED TO U/P NO:.I-29 -j LAYOUT NO '159-2 TITLE CLIENT, DUPLICATION OR USE NEAREST STATION: 108 , WRHOIR THE EXPRESS WRITTEN SIDE OF HIGHWAY:NORTH CONSENT OF THE CREATOR IS __-- - STRiCTLY PROHIBITED. • _ + ,. ..:.a, . ,,. DRAWING SCALES ME INTENDED FOR i _ `0 .,_.; -:,.._... _�N.1_•._-__._.._ .' ._._. _ _ 11'.17.S1ZE PRINTED MEDIA ONLY. _ p WL I I._ olD N:N _ ---- ALL OTHER PRINTED SIZES ARE .. Z)Ol `--- 1 9 I .�L.-I .. - ij ____ _ DEEMED'NOT TO SCALE'. d _.. .µ ..,, ..-.... _ SUBMITTALS I . __ _._._ —. _- . —s --- — REV DATE DESCRIPTION BY _.._ I____ B I1~7 MR Poll Kt r.# .. I 01/30/IE axes owes R .. '.--r-- '. . 1 A I SITE INFO: I _ 1�. — + . r *v J SITE NAME: " -- " .. YARMOUTH_SC2O_MA 41(W - SITE ADDRESS: F. 42UROUTE 6A -2 9 1 OLD • all' KINGS HIGHWAY a kra YARMOUTH, MA 02675 CHECKED BY: DATE: ED _--e 50 100 200 I® 11/28/17 O1 KEY PLAN PROJECT NUMBER: SOU:1•' GRAPHIC SCALE: 1:50 (IN FEET) 20151257305 APPROX. NORTH SHEET NUMBER: POLE COORDINATES r LATITUDE(NA083) LONGITUDE(NAD83) 41'42'&M171'N 70' 18'03.78'W LE- .i - GROUND ELEVATION 42'AM.S,L(NAV088)