HomeMy WebLinkAboutBLDE-22-007144 a
+ Commonwealth of Official Use Only
ii, j ' \ Massachusetts Permit No. BLDE-22-007144
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BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
"" [Rev.1/071
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:6/9/2022
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) 579 BUCK ISLAND RD
Owner or Tenant TURINO ASSOCIATES LLC Telephone No.
Owner's Address 2000 COMMONWEALTH AVE, AUBURNDALE, MA 02466 0
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check a i'1* . is a /rt
Purpose of Building Utility Authorization No.
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Existing Service Amps Volts Overhead 0 Undgrd 0 ' t f' rs �^
New Service Amps Volts Overhead 0 Undgrd 0 No. • Ob. 1r l
s. O0 it
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Miscellaneous work per attached.
Comtplelion of the following table may be waived by sr, .r of Wires.
N
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers
No.No.of Luminaire Outlets No.of Hot Tubs. Generators KVA
No.of Luminaires Swimming Pool Above ❑ T rnd. ❑ NNo.of Emergency Lighting
l,rnd. k
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Gas Burners No.of Detection and
No.of Switches Initiating Devices
No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices
Heat Pump Number - Tons KW No.of Self-Contained
No.of Waste Disposers Totals: Detection/Alerting Devices
Municipal 0 Other:
No.of Dishwashers Space/Area Heating KW Local ❑ Connection
Heating Appliances KW Security Systems:*
No.of Dryers h PP No.of Devices or Equivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Signs No.of Devices or Equivalent
No.of Motors Total HP Telecommunications Wiring:
No.Hydromassage BathtubsNo.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 certif j',wider the pains and penalties of perfuty,that the information on this application is true and complete.
FiRM NAME: REILLY ELECTRICAL CONTRACTORS LIC.NO.: 22960
Licensee: Sean Reilly Signature
Bus.Tel.No.:
(If applicable,enter"exempt"in the license number line.)
Address: 14 Norfolk Avenue, Eastson MA 02375
Alt.Tel.No.:
*Pet 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(cheek one) 0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. (PERMIT FEE: $80.00
Commonwealth of MaMacitudetLs Official Use Onl
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_,�= 1, c� Permit No.
_ !— . beinartmertt o/ ire Service$
_— Occupancy and Fee Checked
e -'_ 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: June 9, 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) 579 Buck Island Road
Owner or Tenant Turino Associates LLC, c/o Omega Healthcare Investors Telephone No. 203-557-4777
Owner's Address 303 International Cir., Ste 200, Hunt Valley, MD 21030
Is this permit in conjunction with a building permit? Yes [1 No V (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 [1 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Nursing: wire replacement whirlpool tub and add controls for
electric door. Laundry Room:wire replacement dryer
Completion of the following table may be waived by the Inspector of Wires.
NoNo.of Recessed Luminaires No.of Ceil.-Susp. Tran KVA(Paddle)Fans f
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.on Initiating on Dete and
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 E Municipal ❑ 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 NofDeieor Wiring:
No.of Devices Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: $800 (When required by municipal policy.)
Work to Start:6/9/22 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 ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information n this a plication is true and complete.
FIRM NAME: Reilly Electrical Contractors, Inc. LIC.NO.: 556 Al
Licensee: Sean Michael Reilly Signature LIC.NO.: 22960-A
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:508-394-3211
Address: 14 Norfolk Avenue,Easton,MA 02375 Alt.Tel.No.:508-400-8936
*Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No.
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. PERMIT FEE: $