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HomeMy WebLinkAboutBLDE-23-000233 - Commonwealth of Official Use Only 4),,i Massachusetts Permit No. BLDE-23-000233 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:7/14/2022 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) 210 STATION AVE Owner or Tenant DENNIS YARMTH REGIONAL SCHOOL Telephone No. Owner's Address STATION AVENUE, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters , Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement of inverters 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 Connection ❑ Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs 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 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: Joseph J Distefano Licensee: Joseph J Distefano Signature LIC.NO.: 21714 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:2 PURCELL DR, BILLERICA MA 018212851 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: $500.00 ° _ i ommonweanit It I fas_4achui.IL ¢{3mcial Use Only 2� �' -0 tc''�� Permit Na. (./2 � r ,1—_ in= 2eparartmsnl o f stro.trvi,cee -- lam"""� Occupancy and Fee Checked W _ i� ,1, BOARD OF FIRE PREVENTION REGULATIONS [Rev_ I/071 t1ea a blank) N Q & PPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK w c) i a ' All work to be performed in accordance with the Ma4sachusctt,Llectrieal Code tMLC:1,527 CMR 12.00 9 1 •,EASE PRINT I,"1r INK OR TYPE'ALL INFOR�1ATIUN') Date: 115 ) a oaa uj' . ';E I City or Town of: S,,t/.1'h ' 'g1M OVA-h To the Inspector of Wires: 1 13) is application the undersigned gives notice of his or her intention to performthe electrical work described below. •` ,, , Lion(Street&Number) a I 0 5+°`Holt f vt-hve M ca(ol0til Owner or Tenant Telephone No. ( i R -3 0 d- o U`w Owner's Address Is this permit in conjunction with a building perry ii? Yes ❑ No PIO (Check Appropriate Box) Purpose of Building H 8)4 Shij&Qo I 0' H;5r1 $Gh 00'i Utility Authorit tion No. Existing Service 's j— nips 111 r 14 aiV'olts Overhead[1 Undgrd�V No.of Meters New Service Amps Volts Overhead❑ Undgrd ❑ No,of Meters Number of Feeders and Ampacity . Location and Nature of Proposed Electrical IA ork: Roa -f +O Completion of the followurz ruble may be waived by the!rivet:tor tJ'Wires. No.ofCeil.-Susp.(Paddle)Fans To q Total No.of Recessed LuminairesTransformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency lighting No.of Luminaires Swimming Pool grnd, grnd. r-i Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and No.of Switchesinitiating;Des lees No.of Air Cond. Total No.of Alerting Devices No.of Ranges No. Beat Pump Number Tons .._KW. ... No.of Self-(:ontained No.of Waste Disposers i Totals: Detection/'Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Odter Heating Appliances KW .ea:uctty SVitems:" No.of Dryers No.of fievices or Equivalent No.of Water h 1A 'No.of No.of Data Wiring: Signs Ballasts No.of Devices or Eq�uivalent No.Hvdromassage Bathtubs No.of Motors Total HP Telecommunications►4'iringgNo.of Devices or Equivalent OTHER: 1 f 0 i~ 4 S(JJ OJ' 0-P S 0Io.v 1 nv21-4.ex-S Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: [ 5O ) (When required by municipal policy.) Work to Start'Uhf 11 aOv>� Inspections to he 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 nerage is in force,and has exhibited proof of same to the permit issuing office. C:IWCK ON F.: INSURANCE ja BOND [] OTHER ❑ (Specify;) .7i -'/ I Li AI certify,under the ins and penalties of perjury,that the information o his application is true and complete. �1 FIRM NA►lE; 60rrei3 o/ Sol/r , dsG10ta- ) 1 5 ra-N10 I,IC.NO.: l icensee: Signature I.1C.NO.:`/ f)r L q Of applicable, enter -exempt"in the licence number dine.) Bus.Tel No.:6 11-t i 65'a.14� t Address: 5 S 1'gtc,Yt 01 tr°J ti1 t J yip G 1< 5 I Alt.Tel.No.: . "Per M.6,I„c. 147.s.S7-fit,security work requires Department ot'Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hove the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner ©owner's agent Owner/Agent PER;LIT FEE: $ Signature Telephone No. C.c .,t, Mal+ ry .per 1L / q - 3d - byz-