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Home My WebLink AboutBLDE-21-004732 ,, Commonwealth of Official Use Only Permit No. BLDE-21-004732 € '4) Massachusetts 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:2/22/2021 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) =Xial134 ANSEL HALLET RD Owner or Tenant Cape Cod Dermatology Telephone No.p 6 Owner's Address MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Che • op ' l i Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd ❑ i I f , J New Service Amps Volts Overhead 0 Undgrd 0 No.o ete s O Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade lighting.(UNIT A 0 134 ANSEL LET ROAD) 40 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 ❑ BOND 0 OTHER 0 (Specify:) 1 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 Commonwealth col//lvwsarhujettl Official Use Only 3 ly�� 2 Z t c� Permit No. - `C— 7 C, M1' 2 epartment 01..tire Serviced ' =1f== 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:2/9/2021 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) 134 Ansel-Hallet Rd.A Owner or Tenant Cape Cod Dermatology LLC Telephone No. 508-771-9779 Owner's Address Same Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Commercial Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace lighting with energy efficient fixtures-2 int.fixtures and 202216 pdavey@riseengineering.com 39 relamp reballast. 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 INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices Tot No.of Ranges No.of Air Cond. Tons No.of Alerting Devices 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 Other Connection 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: $2,000.00 (When required by municipal policy.) Work to Start:2/2021 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE lj BOND 0 OTHER 0 (Specify:) kweather& Shepley Ins. 1/22 I certify,under the pains and penalties of perjury,that the information ap ca • is true and complete FIRM NAME: Thielsch En ineerin ),IC.NO.: Licensee: Ralph Carroccio Signature LIC.NO.: 16657A (If applicable,enter "exempt"in the license number line) Bus.Tel.No..401-784-3700 Address: 1341 Elmwood Ave., Cranston, HI U1990 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.L c.No.No.: 800-422-5365 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the Owner/Agent (check one)0 owner 0 owner's agent. Signature Telephone No. I PERMIT FEE:$ 80.00 I