HomeMy WebLinkAboutBLDE-22-005019 Commonwealth of Official Use Only
�., , •
it Massachusetts Permit No. BLDE-22-005019
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:3/10/2022
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) 469 HIGGINS CROWELL RD
Owner or Tenant TOWN OF YARMOUTH Telephone No.
Owner's Address WATER DEPT/WELLFIELD PURPOSES, 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463
Is this permit in conjunction with a building permit? Yes 0 No 0 (C i• ry; tOtox)
Purpose of Building Utility Authorization , " t
Existing Service Amps Volts Overhead 0 Undgrd sti y,
New Service Amps Volts Overhead 0 Undgrd 0 i. O.o eterr
Number of Feeders and Ampacity ,°
Location and Nature of Proposed Electrical Work: Install new gear&light w -r i ,,,, +,' 4 1i>
Completion of the following table may be teed yyh r ?it
of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of "'',tal
• �_§ i
Transformers ci/
j ,
No.of Luminaire Outlets No.of Hot Tubs Generators
Pool Above ❑ In- ❑ No.of Emergency Lightin �?
No.of Luminaires Swimming 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. Tonal No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
P Totals: Detection/Alerting Devices
Space/Area HeatingKW Local ❑ Municipal 0 Other:
No.of Dishwashers P Connection
HeatingAppliances KW Security Systems:*
No.of Dryers PP No.of Devices or Eauivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Signs No.of Devices or Equivalent
Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP 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: RYAN MELLO LIC.NO.: 22307
Licensee: RYAN MELLO Signature
(If applicable,enter"exempt"in the license number line.)
Bus.Tel.No.:
Address:7 Woodlawn Rd,Assonet MA 027021656 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
a4
RE }C ? E D Can, eat a/niaancluiddh Official Use Only
_ �., Permit N�� t
MAR��� �!' �• � ..�. icy and Fee Checked
1 : o -D OF FIRE PREVENTION REGULATIONS [[tev.1ro7] Ilawe blank)
USING DC ARTMENT
eyB • — _ —-. TION FOR PERMIT TO PERFORM ELECTRICAL WORK
• All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CM 12.00
q (PLEASE PRINT IN INK OR TYPE ALL INFORMATIOA9 Date: 3/4/2022
›, City or Town of: yaI:tt . lh To the Inspector of Wires:
° By this application the undersigned gives notice of hit or her intention=o perform the electrical work described below.
cc
a Location(Street&Number) - u.
no Owner or Tenant yarrnm l'hi r r ,,p, ,,,i- Telephone No. 508-771-7921
Owner's Address 99 Ark Tslarrl R7 , ti=t1- V,rm,* h _hp cam
/4 , Is this permit in con junction with a , ,i ,,, , a ,* Yes ® No [ (Check ., to Box)
rts
Purpose of Building .. Utility Authorization No.
N E Existing Service Amps / Volts Overhead 0 Undgrd ElNo.of Meters
co
New Service Amps / Volts Overhead El Undgrd 0 No.of Meters
a 4 Number of Feeders and Ampacity
N
Location and Nature of Proposed Electrical Work: i b tf eveaut q,,,Q (sy1413 , Di.Satnll,'a►t7
• xlew Grua. LsgkkTS
Consaktlon of thefollowingt able may be waived by the!vector of ice.
• No.of Recessed Luminaires Na of CeIL-Soap.(Paddle)Fans of
Tn®sformers TEA
No.of Luminaire Outlets No.of Hot Tabs Generators KVA
No.of Luminaires S P� Above ❑ In- ❑ no.or amiergeacy L1gnaug
grad. crud. Battery Units
• No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners yAo.of and
evices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
ons
No.of Waste Disposers 'lam Pump Number.Ts__,KW__ 'No.of Self-Contained
Totals: an Detection/ -a ,I Devices
No.of Dishwashers Space/Area Heating KW Local 0 M'' "'' 0 Other
No.of Dryers Heating Appliances KW Securityof Devices or Equivalent
No.or Water No.of No.of Data :
Heaters s Ballasts 'I'eieNo.ofcom= _ or _,;!. ? �t
No.Hydros Bathtubs No.of Motors Total HP No.of Devices or
OTHER:
Attach additional detail Vdestreet or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start 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 ❑ (Specify:)
I eandy,under the pains and penalties of perjury,that the this application is true and complete.
FIRM NAME: SParks CyYr Inc- LIC.NO.:4255 Al
Licensee: Ryan N.Lh Signature itit, I i '
iiiiA LIC.NO.: 22307 A
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.-4012A4Q
Address: gnu Th]1 1 iwr, tvQ. t1777( Alt.Tel.No.:,.774.644.17
•Per M.G.L.c. 147,s.57-61,security work requires Department ogiblic Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVEER: 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 Downer's t.
Signature Telephone No. ( PERMIT FEE:$
Sparks Company,Inc. 0 2y
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#7936429
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:7936429
Disconnect/Reconnect Service - * Work Requested Date: 2022-03-02
Overhead * Job Location:469 HIGGINS-CROWELL ROAD
* Contractor Name:Ryan Mello
Work Request Number: * Contractor Phone Number:4016352440
7936429
NOTE:This email confirms we received your request and does not
Job Location: imply that work will be performed.
469 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.com
Please save this confirmation email for your records.
This is an unmonitored mailbox-please do not reply.
❑x a
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(asparkscompanyinc.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@eversource.com
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
•
EVERS®URCE
ENERGY •
IDENTIFICATION OF METER SOCKETS
Form M-13
Owner's Name Yarmouth Water Department Date 2/2/2022
Service Address 469 Higgins Crowell Road Work Order#
Town Yarmouth
509# 74-6) 00000
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