HomeMy WebLinkAboutBLDE-22-005018 Commonwealth of Official Use Only
4.11 h Massachusetts Permit No. BLDE-22-005018
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev
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)
City or Town of: YARMOUTH Date:To the Inspec022
toBy this application the undersigned gives notice of his or her intention to perform the electrical work described below.r of Wires:
Location(Street&Number) 297 HIGGINS CROWELL RD
Owner or Tenant TOWN OF YARMOUTH
Owner's Address WATER DEPT, 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463Telephone No.
Is this permit in conjunction with a building permit?
Purpose of Building Yes El No 0 (Check a
Utility Authorization No. ..
Existing Service Amps Volts
New Service Overhead El Undgrd 0 , 'IC
Amps Volts Overhead 0
Number of Feeders and Ampacity Undgrd ElNo.of .
'�
Location and Nature of Proposed Electrical Work: Install new •ear&li• s''M,. =- ' `}'
Completion of the following table ma tvvtvd`d by k litiec�o o fWires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of !
Transformers
- 16.14< �
No.of Luminaire Outlets No.of Hot Tubs � 0 `»r'
Generators `f ;' � A No.of Luminaires SwimmingPool Above In_ ' �K
grnd. 0 grnd. ❑ No.of Emergency i
No.of Receptacle Outlets Battery Unit
No.of Oil Burners FIRE ALARMS No.of Zone
No.of Switches No.of Gas Burners
No.of Detection and
No.of Ranges Initiatine Devices
No.of Air Cond. Total
Tong No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number ( Tons I KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW
Local ❑ Municipal 0 Other:
No.of Dryers Heating Appliances Connection
KW Security Systems:*
No.of Water , No.of No.of Devices or Eauivalent
a ers No.of Ballasts Data Wiring:
•No.Hydromassage Bathtubs , o ' t • i • i t i i • e i t
No.of Motors Total HP Telecommunications Wiring:
OTHER: No.of Devices or Eauivalent
Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires.
Work to start: (When required by municipal policy.)
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
I certify,under the pains andpenalties o (Specify;)
fperjury,that the information on this application is true and complete.
FIRM NAME: RYAN MELLO
Licensee: RYAN MELLO
Signature Tel. NO.:.: 22307
(If applicable,enter"exempt"in the license number line.)
Address:7 Woodlawn Rd,Assonet MA 027021656 Bus.Tel.No.:
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 my
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:$0.00
,RECEIVED
1
7.
MAR„ Com„onw.0a o`r//aaaae Official Use Only
m Y 2eloarimeni oi,yyr,J.rvteei Permit No. e.)2,52--- 1, 0
Occupancy and Checked
BUILDING E
By _. !!._
. (l
• RD OF FIRE PREVENTION REGULATIONS 1/07] Fee
acne bleak)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
. All work to be in a with the Massachusetts Electrical
C�
c (PLEASE PRINT IN INK OR TYPE ALL INFORMATT � ��: 3/4/2022
O ( .2 cHttt:z.00
�� mui3�City or Town of: Yau
By this application gives notice of his the undersignedTo the Inspector of Wires:
a or her intention to perform the electrical work described below.
Location(Street&Number
owner yamaph
nvrrtavni-
02 Owner's Tenant
t . Telephone No. 50S-771 7921
er or Tenna
s
.14
99 Arlo Tslarrl Thh , Nauru hl}.D® M3
CliIs thin permit in conjunction with
Purpose of BuMng = Yes El No (Check Appropriate Box)
rtS
... <„
cw Utility Authorization No. 7936497
cn
rn , Existing Service Amps /
x Volts Overhead 0 Undgrd❑ No.of Meters
can Amps / Volts Overhead
` Number of Feeders and Andy Undgrd 0 No.of Meters
Ni
Location and Nature of Proposed Electrical Work: un Gaptn. t�tup (.:q1,r, . TNS�,o11 jut A/
_,` gL�TS °gOwn
of
No.of Recessed Luminaires Cornslatlon o1 thefollowtngtable rrey be woad by the f or of Wires.
1.
No.of Rec No.of CM..SmR(Paddle)Fans Transformers KVA
i n�Outlets No.of Hot Tubs Generators KVA
6
No.of LuminairesSwimming Pool d. 0 n' 0 o.
No.of Receptacle Ovate UnitsNo.of Oil Burners FIRE ALARMS No.of Zones
No.of Switch No.of Gas Burners o.o n a.
No.of Ranges No.of Air Cond.
Tons No.of Alerting Devices
No.of Waste :m ��., „
otale: Detection!o. ;r+;.
No.of Dishwashen Devices
No.of Space/Area Heating KW Local 0 v a ^., ❑Other
o. Heating Appliances Kq, �'�-r �--, ,
o.a Na of ►,_
Heaters 1KW S s Baa.'laab Data Wiring:
No.Hydro Bathtubs No` t
No.of Motors Total HP
OTHER: No.of Devices or t
EstimatedValue of Electrical Work: Attach additional detail V or as
Work toStart: (When required by municipal policy.)by the inspector of Wires.
Inspections to be requested in accordance with MEC Rule 10,
INSURANCE COVERAGE: Unless waivedthe and upon completion.
by owner,no the licensee Provides proof of•liability insurance inn permit for pleted anone coverage
of is substantial electrical work may issuentT unless
CundersHECK Iertifies NSURANCE such coverage is in force, exhibited proof to�witequivalent
I�$'.under the pars and � BOND 0 OTHER 0 ( fj,;) issuing office.
FIRM NAME: : Gt�caf krr00',that the this nPe Is true and amplest
1ZYatz Nhl In LIC.N0.:4255 Al
Licensee:
tcoble,enter"exempt"In the license Signature
Address: manber lb,�) LIC.NO.: 22307 A
*PerM.G.L.c. 147 s.57-61Bus.Tel.No.•
OWNER'S INSURANCE ►security work Alt.Tel.No.�- -ne __
WAIVER: 1 anent° bite Safety"S"License: Lie.No. �'��'°'4.423L
required by SINS By my signature I that the Licensee not have the liability insurance coverage norr—
��Agent below, Y waive this mcNitttrtent. I am the(check one ■owner I owe . ,.y t
Telephone No. PERMIT FEE:$
Sparks Company,Inc. ]y
From: Eversource Do Not Reply <noreply@notifications.eversource.com>
Sent: Wednesday, March 2, 2022 10:54 AM
To: Sparks Company, Inc.
Subject: [EXTERNAL] Work Request Submission Confirmation #7936497
0 =
Dear Valued Customer,
Work Request Submission
Confirmation We received your work request with the following information:
*Request Type:Disconnect/Reconnect Service-Overhead
Work Request Type: * Request Number: 7936497
Disconnect/Reconnect Service - * Work Requested Date:2022-03-02
Overhead * Job Location:297 HIGGINS-CROWELL ROAD
* Contractor Name: Ryan Mello
Work Request Number: * Contractor Phone Number:4016352440
7936497
NOTE: This email confirms we received your request and does not
Job Location: imply that work will be performed.
297 HIGGINS-CROWELL ROAD
Log into your Eversource.com account to track the status of your
request. For questions or to cancel your request, call or email us and
we'll be happy to assist you.
Sincerely,
Eversource Electric Service Support Center.
18886333797
MANewService@eversource.corn
Please save this confirmation email for your records.
This is an unmonitored mailbox-please do not reply.
0 = 0 =
EVERSURCE
ENERGY Work Order Application
Customer Request In-Service Date: Eversource WO Received Date:
Service Address: Street: 297 Higgins Crowell Road Suite: Town: Yarmouth, MA Zip: 02673
Customer of Record:
Customer Responsible for Payment of Monthly Electric Bills
Name to appear on Monthly Bill: Yarmouth Water Department
DBA—CIO Name:
Billing Address: 99 Buck Island Rd, West Yarmouth, MA 02673-3672
Telephone: 508-771-7921 Tax ID Number:
Existing Account or Meter Number(if applicable): 1441-328-0018
Property Owner Name (if different from above):
Owner Address:
Owner Phone Number:
Party Responsible for Construction costs associated with work order(if different from above)
Name:
Address:
Phone Number:
Please Note that Articles of Incorporation are required for new commercial Eversource Customers
Type of Service Requested: (Circle Appropriate)
New Service Service Upgrade Service Relocation Temporary Service
Pole Relocation Disconnect/Reconnect Service Removal Metering Only
OH Service from Pole, Pole#: UG Service from; Riser-Pole#: Padmount# :
Customer Loading Brief Description of Work
Type of Load New Connected Load in KVA Installation of new service disconnect
Single Phase Three Phase meter socket and Panels
Lighting
Electric heat
Air Conditioning
Refrigeration
Cooking
Electric Dryer
Water Heater
Computer
Process Equip.
Motors/Elevators
Miscellaneous
Totals
Number of Meters Required:
Residential: Commercial: 1
Main Switch Voltage: 480 Amperage: 200 Phase:
Phas Service Voltage: 480 e: 3
Amperage: 200 Phase:Facility Type (i.e.: school, hospital): Pump Station Newwtion B3
Building Square Feet:
If more than 1 meter is required, how will meters be labeled?(ie: Unit 1, 2, etc, Unit A, B, etc.)
Additional Equipment:
Generator: KW: Phase: Purpose:
Motor(S) : Total#: Largest HP: Phase: Locked Rotor AMP:
Type of Starting Compensation (choose one): Hard Soft Capacitor VFD
*See Article 802 of Eversource Information and Requirements Book for Maximum LR current and Three Phase Protection *
Contact Name (circle appropriate):
Customer/Contractor/Consultant: Sparks Company, Inc. -Jared Mello
Street Address: 168 Stevens Street
City, State, Zip: Fall River, MA 02721
Telephone: 401-635-2440 Best Time to Call: 7AM-4PM
Pager: Email: Sparks(a�sparkscompanyinc.com
Fax: 401-635-1633
Electrician: Ryan Mello License Number: 22307 A
Business Name: Sparks Company, Inc
Street Address: 168 Stevens Street
City, State, Zip: Fall River, MA 02721
Telephone: 401-635-2440 Best Time to Call: 7AM—4 PM
Pager: Fax: 401-635-1633
Cell: 401-641-5944
Please note that by Interconnecting with Eversource's Distribution System the Customer of Record acknowledges
that they have reviewed and are in compliance with the Eversource Information & Requirements for Electric Service
(Red Book).
For New Commercial Services, New Residential Developments, New 13.8KV Two Line Station Electric Service, please
provide (2) copies of City/Town approved site plans that illustrates the new facility location and the proposed location of the
new utilities(electric, gas, water, sewer, telecommunications)and a One-Line Diagram.
For Service Increases at existing facilities, please submit a One-Line Diagram if available.
For New Residential Services where a pole must be set, please provide(2) copies of a site plan that illustrates the proposed
location of the new facilities.
For Temporary Service Requests, please provide (2)copies of a site plan illustrating service location.
You may Fax this Form or mail any additional correspondence to:
Charles J Tavares
Eversource Energy
180 MacArthur Dr.
New Bedford, MA, 02748
Tel: (508) 441 —5832
charles.tavares(a,eversource.corn
FOR EVERSOURCE USE ONLY
Eversource Revenue Allowance:
Eversource Rate:
KVA or KW rating of Existing Loads (if applicable):
Existing Winter Peak Demand: Month/Date/Year:
Existing Summer Peak Demand:
Month/Date/Year:
Revised 03-05-04
•
EVERSSURCE
ENERGY •
IDENTIFICATION OF METER SOCKETS
Form M-13
Owner's Name Yarmouth Water Department
Date 2/2/2022
Service Address 297 Higgins Crowell Road
Work Order#
Town Yarmouth
5#097083100000
000 000 0
000 000 0
NOTE: This form must be completed and returned before any meters can be installed. EACH meter position must be marked
according to Eversource Information&Requirements for Electric Service. Labeling on this sheet must agree with the labeling on the
meter sockets. Fill in the number of circles to correspond with the number of meter sockets
Section 708. Identification of Meter Sockets
Sample
S-#302
Please complete and submit this form for each meter location for multi-unit buildings
Electrician_ Ryan Mello Telephone# 401-641-5944
License# 22307 A
Requested date of Meter Installation
Received by:
Date
Page of
Revised 03-15-06