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HomeMy WebLinkAboutBLDE-21-005886 X Commonwealth of Official Use Only IliM1111 assachusetts Permit No. BLDE-21-005886 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:4/13/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 620 ROUTE 6A Owner or Tenant BASS RIVER ROD&GUN CLUB INC Telephone No. Owner's Address 620 ROUTE 6A, YARMOUTH PORT, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 . . = s .:, New Service Amps Volts Overhead 0 Undgrd 0 o. , e O w' Number of Feeders and Ampacity .k.. Location and Nature of Proposed Electrical Work: Upgrade lighting. Completion of the following table may b.41 e43 eSil(s of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of tal Transformersit No.of Luminaire Outlets No.of Hot Tubs Generators ` A 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 AlertingDevices 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 Connection ❑ Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of 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: 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: THIELSCH ENGINEERING INC Licensee: RALPH A CARROCCIO Signature LIC.NO.: 16657 (If applicable,enter"exempt"in the license number line.) Address: 1341 ELMWOOD AVE, CRANSTON RI 02910 A ..Tel. o.:: All *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: t.Tel.No.: 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. I I PERMIT FEE: $80.00 r ACommonwealth o`///a&lachudelts Official Use Only cc�� c7 gg C� 1g. t 2e artmenl o Pire Services Permit No. l�� " P ' =1 f Occupancy and Fee Checked t 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:4/1/2021 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)620 Route 6A Owner or Tenant Bass River Rod &Gun Club Telephone No. 508-362-3292 Owner's Address Same Is this permit in conjunction with a building permit? Yes ❑ No © (Check Appropriate Box) Purpose of Building Commercial Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd E No.of Meters New Service Amps / Volts Overhead E Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace lighting with energy efficient fixtures-12 int.fixtures. 00852 pdavey@riseengineering.com s Completion of the followin�tabde may be waived by the Inspector of Wires. jo.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA tea c-� o.of Luminaire Outlets No.of Hot Tubs Generators KVA -= c_ No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of emergency Lighting a {ram grnd. rnd. Battery Units ' u 9 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 Devicesw--______No.of Ranges No.of Air Cond. TonTots No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal p Local❑ Connection 0 Other No.of Dryers Heating Appliances KW security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of 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: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: $1,500.00 (When required by municipal policy.) Work to Start:4/2021 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 ® BOND 0 OTHER ❑ (Speci :) a weather& Shepley Ins. 1/22 I certify,under the pains and penalties of perjury,that the informs . i appl. on is true and complete FIRM NAME: Thielsch Engineering � — ��U".N8: Licensee: Ralph Carroccio Signature (If applicable,enter "exempt"in the license number line.) LIC.NO.: 16657A Address: 1341 tlmwooa Ave., Uranston, KI 02910 Bus.Tel.No.;401-784-3700 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.L c.No. 800-422-5365 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: $ 80.00 I