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Home My WebLink AboutBLDE-23-005958 e Commonwealth of Official Use Only `97 Massachusetts Permit No. BLDE-23-005958 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;4/27/2023 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) 573 HIGGINS CROWELL RD Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address WATER DEPT, 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463 , / Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Bow /t��0�+ Purpose of Building Utility Authorization No. 7936866 l/.i1�tot 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: Upgrade service&lighting (PUMP STA.#20) 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 Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent 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: RYAN MELLO Licensee: RYAN MELLO Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 22307 Address: 7 Woodlawn Rd,Assonet MA 027021656 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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 Owner/Agent ) 0 owner 0 owner's agent. Signature Telephone No. ,,� PERMIT FEE: $0.00 1Z-s IJ17 le-S (Io- A,) c 1 R. FcEIV P- -4 = . 26 202 0171/t7ol7WE'alth of Massachusetts Official Use Only * Permit No.: ;'iZ"3-- -9.S,n �;=? Department of Fire Services Occupancy and Fee Checked: (; �?-7-7 BOARE`OF IRE PREVENTION REGULATIONS [Rev. I/2023] - }''``-'"4� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527 CMR 12.00 City or Town of: YARMOUTH - Date: 3- Z4- 2023 To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the electrical work described below. Location(Street&Number): 573 t4.19;a3 Ciio►JEi 1 I?D Unit No.: Owner or Tenant:-7-6w J o F VAR M j l4, Email: Owner's Address: q.�-(2 j)1. , //g/fr R2s Z$ 5dv4in Yl&MdU . Phone No.: Is this permit in conjunction with a building permit?(Check appropriate box)Yes E J No❑Permit No.: Purpose of Building: Utility Authorization No.: 993 1p&( (p Existing Service: '2o0 Amps 'p / 2?'7,Volts Overhead❑ Underground L' No.of Meters: t New Service: 2a Amps ift, / 23r Volts Overhead D Underground[R. No.of Meters: / Description of Proposed Electrical Installation: tj3./a// A/61i /JJLs lie+D L:ci L13 p ` 2o p Completion of the following table may be waived by the Inspector of Wires. No.of Receptable 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 0 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.Air Conditioners: Total Tons: y 0 No.of Devices: Telecom System❑ No.of Outlets: No.Energy Storage Systems: KWH Storage Rating: SecuritySystem stem y El 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: OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Date Work to Start: (When required by municipal policy) 3-24- 2023 Inspections to be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: Segal/5 Campaitiyriot A-1 [vror C-1 0 LIC.No.: Liz$'5-- Master/Systems Licensee: Ry/fa Mt(lo LIC.No.: 2130'4 4 Journeyman Licensee: LIC.No.: Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: Address: {?,p -gtx so34 -if a ik.r, , ► 4A 029,7.7 Email: E�h ( 'e G►s 1/ iRe+ 1. _CottA • Telephone No.: 1-WO/ - .(2'3S- - 'two I certify,u r the ai s and penalties of perjury,that the information on this application is true and complete. Licensee: Print Name: INSURA E COVERAGE: Unless waived by the owner,no ermit for the performance of electrical work may issueunless the lie eyy provides pr f of liability 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 IRr BOND❑ OTHER❑ Specify: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 0 Owner/Agent: Signature: Tel.No.: Email.: