HomeMy WebLinkAboutBLDE-22-004159 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-22-004159
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:1/26/2022
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) 7 DUPONT AVE
Owner or Tenant FUSHI-MAHONEY LAUREN JANE Telephone No.
Owner's Address PROGRESSIVE REALTY TRUST, P 0 BOX 174, SOUTH YARMOUTH, MA 02664-1203
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 ❑ Undgrd 0 No.o(,lMett►rs
New Service Amps Volts Overhead 0 Undgrd 0 No.of-IS/titers
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Upgrade lighting (WAREHOUSE 5&6)
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 23 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/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other:
Connection
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: EVANDRO R SOUSA
Licensee: Evandro R Sousa Signature LIC.NO.: 53191
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:202 N QUINSIGAMOND AVE, SHREWSBURY MA 01545 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: $80.00
RECEi,...
IVED
_ .,_,.- C.,ommo,uvea[th o////aeaachu9sth Official Use Only
JAN -- •/ c�r� c7 Permit No. '-2�' S
t 2)eparfmsnt o/.}ire&reics�
Occupancy and Fee Checked
BUILDING D`'_ NT { a (leave blank)
By:_ ___ _ . 11 ___BOARD OF FIRE PREVENTION REGULATIONS 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: 01/12/2022
City or Town of: Yarmouth-Ma To the Inspector of Wires:
v By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Li
Location(Street&Number) 5 Dupont Av
Owner or Tenant Progressive Realty Trust Telephone No. 774 268-9448
co Owner's Address
4_' Is this permit in conjunction with a buildingpermit? Yes RI (Check Appropriate
No Box)
4rPPuose of Building Commercial Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters
p;
(4,1 New Service Amps / Volts Overhead❑ Undgrd n No.of Meters
Number of Feeders and Ampacity
47 Location and Nature of Proposed Electrical Work: lighting upgrade:warehouse,unit 5 and 6
Completion of the followingiable may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
n
No.of Luminaires 23 SwimmingPool Above In- No.of Emergency Lighting
grnd. ❑ grnd. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
` ofGas No.of Switches No. Burners -No.of Detection and
Initiating Devices
I`' No.of Ranges No.of Air Cond. Total No.of AlertingDevices
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 ❑ Other
Connection
No.of Dryers Heating Appliances KWSecurity Systems:*
No.of Devices or Equivalent
No.of Water , No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wirin :
No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: $ 00 (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 gj BOND ❑ OTHER ❑ (Specify:)
I certify, under the pains and penalties of perjwy,that the information on this application is true and complete.
FIRM NAME: BAY STATE ELECTRICAL SOLUTIONS CORP LIC.NO.: 22277
Licensee: Evandro R Sousa Signature EMI/AV-SU-LGlrtUU LIC.NO.: 53191
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:833-710-1508
Address: 7203 TIMBERVIEW WAY,Marlborough ma 01752 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)❑owner ❑owner's agent.
Owner/Agent 6
Sionatnre Telenhone No. I PERMIT FEE: $ U -- 1