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Home My WebLink AboutBlde-19-000010 V ' R r Commonwealth of Official Use Only �. fi-`. Massachusetts Permit No. BLDE-19-000010 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:7/2/2018 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) 383 ROUTE 28 Owner or Tenant W YARM CONGREGATIONAL CHURCH Telephone No. Owner's Address 383 ROUTE 28,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Ch joi•• A• s . kox) Purpose of Building Utility Authorization No Existing Service Amps Volts Overhead 0 Undgrd 0 r New Service Amps Volts Overhead 0 Undgrd 0 IllTztt7A Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade lighting O O Completion of the following table may be wai ' ctor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Al Transformers , No.of Luminaire Outlets No.of Hot Tubs Generators VA 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 Initiating 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/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 0 BOND 0 OTHER 0 (Specify:) 7 certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: THIELSCH ENGINEERING INC Licensee: RALPH A CARROCCIO Signature LIC.NO.: 16657 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 1341 ELMWOOD AVE,CRANSTON RI 02910 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 r Commonwealth.al a.1Jachuletts Official Use Only /f� cc�� c�77 Permit No. 09 C = .2)epartment o/.}ire.Service] =iv = Occupancy and Fee Checked -_ BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) 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:6/19/2018 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)383 Route 28 Owner or Tenant W.Yarmouth Congregational Church Telephone No. 508-775-0891 Owner's Address Same Is this permit in conjunction with a building permit? Yes n No n (Check Appropriate Box) Purpose of Building Commercial Utility Authorization No. Existing Service Amps / Volts Overhead n Undgrd n No.of Meters New Service Amps / Volts Overhead n Undgrd I I No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace lighting with energy efficient fixtures-16 relamp reballast 71235 22 fixtures, and cooler lights. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices Total No.of AlertingDevices No.of Ranges No.of Air Cond. Tons No.of Waste Disposers HeatPump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ElM Connection Municipal ❑ Other Heating Appliances KW Security Systems:* No.of Dryers No.of Devices or Equivalent No.of Water Kam, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: $6,000.00 (When required by municipal policy.) Work to Start:6/2018 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 a' e to the permit issuing office. CHECK ONE: INSURANCE ❑X BOND ❑ OTHER ❑ (Specify•, /r her & Shepley Ins. 1/19 I certify,under the pains and penalties of perjury,that the information /i cation is true and complete. FIRM NAME: Thielsch Engineering LIC.NO.: Licensee: Ralph Carroccio Signature y / / LIC.Isla. 16657 A •(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:401-784-3700 Address: 1341 timwood Ave., Cranston, Ili U2 31U Alt.Tel.No.:800-422-5365 *Per M.G.L.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 PERMIT FEE: $ 80.00 Signature Telephone No.