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HomeMy WebLinkAboutBLDE-23-16041 6/12/23,6:30 AM about:blank Commonwealth of Massachusetts ©g Y * Town of Yarmouth ELECTRICAL PERMIT , Job Address: 296 STATION AVE Unit: Owner Name: DENNIS YARMOUTH REG SCHOOL Owner's Address: 296 STATION AVE Phone: Email: Purpose of Building Commercial Utility Authorization No.: Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-16041 Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters: New Service Amps/Volts Overhead ❑ Underground❑ No.of Meters: Description of Proposed Electrical Installation: Inspections (Up to 3)for new auditorium No.of Receptacle Outlets: No.of Switches: Generator KW Rating: Type: No. Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating: No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No. Motors: Total HP: Total KW: No. Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of Devices: Swimming Pool: In-Grnd.❑ Above-Grnd.❑ Hot Tub❑ No.of Self-Contained Detection/Alerting Devices: No.Oil Burners: No.Gas Burners: Video System ❑ No.of Devices: No.Air Conditioners: Total Tons: Telecom System ❑ No.of Outlets: No. Energy Storage Systems: KWH Storage Rating: Security System ❑ No.of Devices: Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment: No.of Modules: Roof-Mount❑ Ground-Mount❑ Level 1 ❑ Level 2❑ Level 3❑ Rating: Estimated Value of Electrical Work: $ 1 Work to Start: June 12, 2023 FIRM NAME: License Number: Master/System and/or Journeyman Licensee: MICHAEL J REYNOLDS License Number: 20153 Security System Business requires a Division of Occupational Licensure "S" LIC. License Number: Address: East Weymouth, MA, 021893102 East Weymouth MA 021893102 Fee Paid: $240.00 Email: bjacobus@anneseelectric.com Business Telephone: 781-337-6462 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. INSURANCE: about:blank 1/1 a,u.i.rrwnwe"ccii Cr I ritz4aacnuaeui 1 "•"�'a •. July 1 ' lC-0: tt'y�, �'77 ( Permit No. �2-1 ,'\ (p 04 I I ev A 2eparfrnent o�Mire Serviced --- (t-tV Occupancy and Fee Checked '..,�. BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All workto be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / . /2- , City or Town of: Y4 ii-- o .i - 1 t :- 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) -'7 Co, 7-7 0 A o,./ µ Owner or Tenant 1>\%-li A e; /e',.,,,,t. L.. `>c( -,,.r�2,,.... , S t, t i-Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No. ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ,, /7)/ ---a, ..{ ' - :jj ;,- - rw .. , x completion of the followin:table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No,of tal Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool A l ove ❑ In= 0 'o.o mergeacy ig rung 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. Tonsl No.of Alerting Devices No.of Waste Disposers Heat amp Number Tons KW No.of Serf-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ �er No.of Dryers Heating Appliances KW ecurity Aystems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: HeatersSigns Ballasts No,of Devices or Equivalent No.Hydrornassage 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: 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 0 BOND 0 OTHER ❑ (Specify:) I certz,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME ._ 6--LE T t -( ... LIC.NO.: Licensee: L{, :'jr) . ) c"t/A.st xw- .. Signature ---2,--\-- -- LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address _4.C6 .2-./<3 ; P<-"s7rzr el, L.-- 1-= 4.147 .7- i "11 e.:",7 Alt.TeL No.: *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)0 owner 0 owner's agent. Owner/Agent Signature __ Telephone No. PERMIT FEE: $