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Home My WebLink AboutBLDE-19-005263 of.."r Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-005263 \"`... `' 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 p rt rm the electrical work described below. Location(Street&Number) 2 MILL LN i-3724 rq� / Owner or Tenant hi-R Telephone No. Owner's Address , MA 02601 ,,g, Is this permit in conjunction with a building permit? Yes 0 No 0 (MeatsOpeiite ' / Purpose of Building Utility Authorization R�ii�, 24T Existing Service Amps Volts Overhead 0 Undgrd 0 *o.of Meters 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 1/15 @ 2 Mill Lane,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 ❑ 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:) 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 1 c 14 Conastoauveaett►o j MassaciaussHs //�i�cl Use Only �� ` •r c� c� Permit No.E �J �f� / 2/tartness/o/..tier Ssrvrcae BOARD OF FIRE PREVENTION REGULATIONS [Rev. lro7) and Fee Checked (leave bleak) 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 TYP INFORMATION) Date: J ?�'/I City or Town of: ncnyr'�f To the Inspector of Wires: By this application the undersign gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) L /t1/4.L. L , 7- -- 6 A Owner or M 1/toit,ram.. /,e/e ff. Telephone No. 4,7-Xrz/- 73 Owner's Address //P )!. a1Oe"ce /1-4 / Gt/ksr,� "4 eP/5 ' Is this permit in conjunction with a b°ili permit? Yes gj No ❑ (Check Appropriate Box) ,7 Purpose of Building U77e 17 'k Utility Authorization No. a/7 7 09 9 Existing Service Amps / / Volts Overhead❑ Undgrd❑ No.of Meters New Service 4,6 Amps /be, /2)0 Volts Overhead[i. Undgrd❑ No.of Meters / Number of Feeders and Ampadty 3 - 3 1'/04,liJ 6 0 /5}r�� $ rti t0i Le_ Location and Nature of Proposed Electrical Work: Z . A— m C.4<- ,, .cn` / //'tA✓, ,-- •s v/fLdr..A.,44/4 Oi✓ Llj/��s s`L # iS .,) opew 'i.._ f c `l�- A /Y,�1^.j/E.v.,,✓J. !/ j/ ,, Completion ofthe followin&table m�be w by the Ingtector of Wires. lU No.of Recessed Luminaires No.of CelL-Snap.(Paddle)Fans Transformers KVAi gNo.of Luminaire Outlets No.of Hot Tubs Generators KVA 1 Above In- No.of Emergency Lighting Na.of LuminairesSwimming Pool grnd. ❑ grnd. ❑ Battery Units '2 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 i ti No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Rest ootamis: Number.Toes KW __ No.ofSelf-Contained rtiotpevices No.of Dishwashers Space/Area Heating KW Local❑ Connection Municipal ❑ Other No.of Dryers Heating Appliances KW Nlecua ofS setces or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.H dro 8 a Bathtubs No.of Motors Total HP Telecommunications W g. Y No.of Devices or EQnivent OTHER: ? r-.illy/7 `?Jc' , .✓n i7 fr e e: is ram..-�4.z-- e,a Attach additional'detail if desired or as required by the or of Wires. Estimated Value of Electrical Work:'/3 4/Li ' (When required by municipal policy.) Work to Start 3— /1-&/7 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 lif BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties ofperjarry,that the information on this application is tine and complete. FIRM NAME: Pe la c.r/ip-4 k/�'c/tit/e w1 eip.�r. �11,. LIC.NO.:/9"/92-ff Licensee: , r,� `�tt-ke•.�J'/c1 Signature Q �'/fjt/� LIC.NO.: ,9/J I f tf (If applicable.enter"exempt"in the license number line) j Bus.TeL No 7J/ �,f/rya Address: 5/j 7-esi a tirr LA) linen v1 /'ti h /J2/G 7 Alt TeL No.:0/7-L13--Lb,1 *Per M.G.L.c. 147,s.57-61,security work requires Departr€nt 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. 1 am the(check one)❑owner 0 owner's a Owner/Agent Telephone No. L PERMIT FEE:$ Signature PREPARED BY: SITE NAME: YARMOUTH_SC19_MA LOCATION CODE: 1 N E>: I U S 388935 cel SITE ADDRESS: AME OFFICE: UTILITY POLE NO.: 1/15 7A LYBERIY WAY WESTFORD,MA 01855 2 MILL LANE (OLD KINGS 1(972)755-1882 HIGHWAY-ROUTE 6A SIDE) YARMOUTH, MA 02675 ESN OF Aqy,81 r JIMMY N EXISTING --- CHENDANA I* u/ STRUCTURAL y ` t .ksls w Ib.53634 / t EXISTING J• ( 0. _.t.\ J f SSa.,s. U/P !�^// /'- —.Flo 'AMAL YJ'" .-1"--.. ..• _ - ~ 1/30/2018 ...PROPOSED LESSE - 14 NNA& :,,,"" ",."'y✓']8e•« NRN MOUNTED TO U/P NC) 1/15 .— - , -. G L LAYOUT NO: 158-3 t1� / I 'G NEAREST STATION: 182 "/�_� P / THIS DOCUMENT IS THE DESIGN Ti SIDE OE HIGHWAY;NORTH /" IPROPERTY AND COPIMGHT OF NEIBUS DOR ME EXCLUSIVE USE BY THE f TITLE CUENT. DUPLICATION OR USE . WITHOUT THE EXPRESS WRITTEN ..` / / CONSENTSTRICTLY PROHIBITED. R 15 8 N t�e511NG., I ^.- ,in DRAWING SCALES ARE INTENDED FOR �, j �, .!/ I i I I's17"SIZE PRINTED MEDIA ONLY, /- ri 'b I I ALL OTHER PRINTED SIZES ARE / p,' j DEEMED NOT TO SCALE /i. SUUMTRALS / / REV DATE DIISCIUPITUN BY ". >t� • 8 / I. 0 111/07/1P TOR 1q/T IYO /.ti 1 O1/aVti KO OS OWN[ to / \,, �, �.r �� SITE 1N1ro" - �` / „/ '/ 147cIS11NT. k1•y,.>"Jp jj: P may'"" .. SITE NAME: U/P # ,,.r ' i YARMOUTH_SC19_MA / r SITE ADDRESS: �,� % r / 1 2 MILL LANE (OLD KINGS i" s HIGHWAY-ROUTE 6A SIDE) YARMOUTH, MA 02675 CIIECREU BY: DATE: 5=---0 SO 100 200 1BB12/20/17 eKEY PLAN, PROJECT NUMBER: O SCALE,1• GRAPHIC SCALE: 1;50 (IN FEET) 20151257304 SHEET NUMBER: APPROX. NORTH LATITUDE(NA083) LONGITUDE(NAD83) POLE ELEINATES VATION 111 1 41.42' 11.63*N 70• IS'22.55*W GROUND ELEVATION 28'AM.S.L.(NAV088) y1 "A