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HomeMy WebLinkAboutBLDE-22-001806 r n QQ/ q� Official Use 0�1���� C.ommonwea�L o f//laedac�e� • c��i � cc�� c7 • Permit No. Q 'r: * " t 2)epartmen.t o/..}ire Serviced Occupancy and Fee Checked W N \, --1=F BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) w 1 PPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK (D All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 0 lU-J ASE PRINT IN INK OR TYPE ALL INFORMATION) Date:9/29/2021 LLJYARMOUTH To the Inspector of Wires: $1_,— City or Town of: re a,is application the undersigned gives notice of his or her intention to perform the electrical work described below. ocation(Street&Number)703 ROUTE 28 UTILITY POLE#37/124S Owner or Tenant VERIZON WIRELESS Telephone No. 781-585-0040 Owner's Address 118 FLANDERS RD,WESTBOROUGH MA Is this permit in conjunction with a building permit? Yes ❑ No g (Check Appropriate Box) Purpose of Building UTILTY POLE #37/124S Utility Authorization No.6561951 Existing Service Amps / Volts Overhead ❑ Undgrd n No.of Meters New Service 100 Amps 2 4/ 0 Volts Overhead Undgrd❑ No.of Meters 1 Number of Feeders and Ampacity 3-3 THHN 100 AMPS Location and Nature of Proposed Electrical Work: 100 AMP SERVICE ON UTILITY POLE TO PROVIDE POWER TO POLE TOP ANTENNA AND ANTENNA RADIO EQUIPMENT ON POLE Completion of the followingjable 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 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 Detection and No.of Switches No.of Gas Burners Initiating Devices Total No.of Alerting Devices No.of Ranges No.of Air Cond. Tons Heat Pump I Number 'Tons I 1 KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Municipal Other No.of Dishwashers Space/Area Heating KW Local❑ Connection Security Systems:* No.of Dryers Heating Appliances KW No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: KW Ballasts No.of Devices or Equivalent Heaters Signs Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: METER SOCKET, MAST, 12 CIRCUIT Attach PANEL,dditional MINIail t SURGE desired,or as ePROTECTOR quired by the rofWires. Estimated Value of Electrical Work: $2550 (When required by municipal policy.) Work to Start:9/29/21 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 Q! BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and LIC.NO complete. FIRM NAME: NEW ENGLAND ELECTRICAL CONT CORP LIC.NO.:A17295,E36258 Licensee: JOHN BORKOWSKI Signature .:As569oao Bus.Tel.No.: (If applicable,enter "exempt"in the license number line.) Alt.Tel.No.:67'z85 00 3 Address: 21 MARION DRIVE KINGSTON MA 02364 *Per M.G.L.c. U s.SCEIWAIVER: Irk am aware thaes t Licensee does not have the liability insurance nt of Public Safety"S"License: Lic.No. overage normally OWNER'S INSURANCEone required by law. 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