HomeMy WebLinkAboutBLDE-24-293 #250 S S DR 2/23/24,6:48 AM about:blank
Commonwealth of Massachusetts of YA
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Town of Yarmouth . , s d�
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ELECTRICAL PERMIT
Job Address: 0 SOUTH SHORE DR Unit:
Owner Name: TOWN OF YARMOUTH
Owner's Address: 1146 ROUTE 28 Phone: Email:
Purpose of
Building Commercial Utility Authorization No.: 16362880
Is this permit in conjunction with a building permit? No Permit Number: BLDE-24-293
Existing Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
New Service Amps/Volts Overhead 0 Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Temp Service (250 South Shore Drive)
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: ln-Grnd.❑ Above-Grnd.❑ Hot Tub O No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System 0 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 0 Level 1 0 Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $0 Work to Start: February 23, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: PATRICK . LEWIS License Number: 56834
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: WEST ROXBURY, MA, 02132 WEST ROXBURY MA 02132 Fee Paid: $0.00
Email: Paulb@revoliconst.com Business Telephone: 508-520-2350
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:
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BOARD OF FIRE PREVENTION REGULATIONS Rev, lIO1J Itcxyr ►tnnk . ........ ...,... ..,... _. j
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All wort tea he perforated in sccoriliatet with the M ssachusetts Virciik al Lode(MEC"), 527 CM 12.00
(PLEASE PRINT IN MK OR TYPE ,rNFORIWATI N) Date: �
Cityor Town of: - i _ To the Inspector o Wires:
to
By this application the undersigned giv notice of is or her intention perform the electrical work described below.
Location (Street & Number).._.....__._.. 2 ',_ () `:" 7C 'CC_J cis) 1
Owner or Tenant Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box)
t'uri ose of Building Utility Authorization No,
I Existing Sers°ice Amps / Volts Overhead ❑ Undgrd [1 No. of Meters
New Service R' ,, :.. Amps / Volts Overhead Undgrd ❑- '__ No. of Meters
Number of Feeders and Ampacity
it Location and Nature of Proposed Electrical Work: ail ( l . .....,
Completion of the followingtable in...9,be waived 1v the inspector of Wires.
No. of Recessed Luminaires No. of Cell.-Snap. (Paddle) Fans
titNo, of Total
ekiTransformers KVA
Q. No. of Luminaire Outlets No. of Hot Tubs Generators KVA
Above In- 'No. of Emergency lighting
:' No. of Luminaires Swimming Pool
rnd ❑ end. ❑ Battery Units
`„:2 No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones
No. of Detection and
No. of Switches No.of Gas Burners initiating Devices
t t_. No. of Ranges No. of Air Cond. Total No. of AlertingDevices
Tons
Heat Pump Number. Tons W No. of Self-Contained
No. of Waste Disposers Totals: --� -- _.'KW_.-__--._-�_.. Detection/Alerting Devices
No. of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other
Connection
No. of Dryers Heating Appliances KW Security Systems:* 1
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 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 0 (Specify:)
I certify, under the pa ns and penalties o ,perjury, that the information on this application is true and completer-
A.FIRM NAME: `v. Alt,,.\'..,. C( e ( Of I. ~-- -`r ' L1C.NO.: 18; '
r i ,.
Licensee: f z r h Signature j: LIC. NO.:
(If upplicah/e, enter "exempt"in the ic,ense number line.) Bus.Tel. No.:_._.._
Address: Alt,Tel. No.:
*Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" Liccnsc: Lic. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hare 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. rc&viiT FEE:$ I
TEVERS : URCE
ENERGY Work OrderApplication
A lication
kv
Customer Request In-Service Date: Eversource WO Received Date:
Service Address: Street: 250 S. Shore Drive. Town: Yarmouth Zip: 02664
Customer of Record:
Customer Responsible for Payment of Monthly Electric Bills
Name to appear on Monthly Bill: Revoli Construction Co. Inc.
DBA — CIO Name:
Billing Address: 90 Earls Way Franklin, MA. 02038
Telephone: 508-520-2350 Tax ID Number: 04-2897790
Existing Account or Meter Number (if applicable):
Property Owner Name (if different from above): Town of Yarmouth
Owner Address: 74 Town Brook Rd. Yarmouth MA. 02664
Owner Phone Number: 508-398-2231
Party Responsible for Construction costs associated with work order (if different from above)
Name: Revoli Construction Co. Inc.
Address: 90 Earls Way Franklin, MA. 02038
Phone Number: 508-520-2350
Please Note that Articles of Incorporation are required for new commercial Eversource Customers
Type of Service Requested: (Circle Appropriate)
New Service Service Upgrade Service Relocation em•orary Servtc
Pole Relocation Disconnect/Reconnect Service Removal e e S y y
OH Service from Pole, Pole#:UP no # across from UP 22/50 on S. Shore Drive UG Service from; Riser-Pole #:
Customer Loading Brief Description of Work
Temporary service for dewatering purposes for
Type of Load { New Connected Load in KVA
Town of Yarmouth Sewer Project.
Single Phase Three Phase
Lighting_. _.-.......... �._
Electric heat
Air Conditioning
Refrigeration
Cooking
Electric Dryer
Water Heater
Computer
Process Equip.
Motors/Elevators <30 KvA
Miscellaneous
Totals <30 KvA
Number of Meters Required:
Residential: Commercial: 1 Public:
Main Switch Voltage: 240 Amperage: 200 Phase: Single
Service Voltage: 240 Amperage: 200 Phase: Single
Facility Type (i.e.: school, hospital): Outdoor Temporary Service New Building Square Feet:
If more than 1 meter is required, how will meters be labeled? (ie: Unit 1 , 2, etc, Unit A, B, etc.)
Additional Equipment:
Generator: KW: Phase: Purpose:
Motor(S) : Total# : Largest HP: Phase:
Locked Rotor AMP:
Type of Starting Compensation (choose one): Hard Soft Capacitor VFD
*See Article 802 of Eversource Information and Requirements Book for Maximum LR current and Three Phase
Protection *
Contact Name (circle appropriate):
Customer/Contractor/Consultant: Revoli Construction Co. Inc.
Street Address: 90 Earls Way (Paul Bunker)
City, State, Zip: Franklin, MA. 02038
Telephone: 978-815-7825 Best Time to Call: 7am-5pm
Pager: Fax: 508-520-2355
Cell: 9788157825
Electrician: Patrick Lewis License Number: 23565-A
Business Name: HMS
Street Address: 351 Grove St.
City, State, Zip: West Roxbury, MA. 02132
Telephone: 6179471526 Best Time to Call: 7am-5pm
Pager: Fax:
Cell: 6719471526
Please note that by Interconnecting with Eversource's Distribution System the Customer of Record
acknowledges that they have reviewed and are in compliance with the Eversource Information & Requirements
for Electric Service (Blue Book).
For New Commercial Services, New Residential Developments, New 13.8KV Two Line Station Electric Service,
please provide (2) copies of City/Town approved site plans that illustrates the new facility location and the proposed
location of the new utilities (electric, gas, water, sewer, telecommunications) and a One-Line Diagram.
For Service Increases at existing facilities, please submit a One-Line Diagram if available.
For New Residential Services where a pole must be set, please provide (2) copies of a site plan that illustrates the
proposed location of the new facilities.
For Temporary Service Requests, please provide (2) copies of a site plan illustrating service location.
You may Fax this Form or mail any additional correspondence to:
Brian Mello
Eversource Energy
50 Duchaine Blvd.
New Bedford, MA, 02745
Tel: (508) 441 —5832
brian.tnello@eversource.com
FOR EVERSOURCE USE ONLY
Eversource Revenue Allowance: Eversource Rate:
KVA or KW rating of Existing Loads (if applicable):
Existing Winter Peak Demand: Month/Date/Year:
Month/Date/Year:
Existing Summer Peak Demand:
Additional Equipment:
Generator: KW: Phase: Purpose:
Motor(S) : Total# : Largest HP: Phase:
Locked Rotor AMP:
Type of Starting Compensation (choose one): Hard Soft Capacitor VFD
*See Article 802 of Eversource Information and Requirements Book for Maximum LR current and Three Phase
Protection *
Contact Name (circle appropriate):
Customer/Contractor/Consultant: Revoli Construction Co. Inc. (Paul Bunker)
Street Address: 90 Earls Way
City, State, Zip: Franklin, MA. 02038
Telephone: 978-815-7825 Best Time to Call: 7am-5pm
Pager: Fax: 508-520-2355
Cell: 9788157825
Electrician: Patrick Lewis License Number: 23565-A
Business Name: HMS
Street Address: 351 Grove St. •
City, State, Zip: West Roxbury, MA. 02132
Telephone: 6179471526 Best Time to Call: 7am-5pm
Pager: Fax:
Cell: 6719471526
Please note that by Interconnecting with Eversource's Distribution System the Customer of Record
acknowledges that they have reviewed and are in compliance with the Eversource Information & Requirements
for Electric Service (Blue Book).
For New Commercial Services, New Residential Developments, New 13.8KV Two Line Station Electric Service,
please provide (2) copies of City/Town approved site plans that illustrates the new facility location and the proposed
location of the new utilities (electric, gas, water, sewer, telecommunications) and a One-Line Diagram.
For Service Increases at existing facilities, please submit a One-Line Diagram if available.
For New Residential Services where a pole must be set, please provide (2) copies of a site plan that illustrates the
proposed location of the new facilities.
For Temporary Service Requests, please provide (2) copies of a site plan illustrating service location.
You may Fax this Form or mail any additional correspondence to:
Brian Mello
Eversource Energy
50 Duchaine Blvd.
New Bedford, MA, 02745
Tel: (508) 441 —5832
brian.melloCa7ever4c7urcr etnn
FOR EVERSOURCE USE ONLY
Eversource Revenue Allowance:
Eversource Rate:
KVA or KW rating of Existing Loads (if applicable):
Existing Winter Peak Demand;
Existing Summer Peak Demand. Month/Date/Year.
Month/Date/Year:
. , w .t. 1
,_
\/ERSURCE ENERGY Work Order Application
-7-jjt,2 7 J
Customer Request In-Service Date: Eversource WO Received Date:
Service Address: Street: 250 S. Shore Drive. Town: Yarmouth Zip: 02664
Customer of Record:
Customer Responsible for Payment of Monthly Electric Bills
Name to appear on Monthly Bill: Revoli Construction Co. Inc.
DBA—C/O Name:
Billing Address: 90 Earls Way Franklin, MA. 02038
Numb 04-2897790
Telephone: 508-520-2350 Tax
Existing Account or Meter Number(if applicable):
Property Owner Name (if different from above): Town of Yarmouth
Owner Address: 74 Town Brook Rd. Yarmouth MA. 02664
Owner Phone Number: 508-398-2231
Party Responsible for Construction costs associated with work order(if different from above)
Name: Revoli Construction Co. Inc.
Address: 90 Earls Way Franklin, MA. 02038
Phone Number: 508-520-2350
Please Note that Articles of Incorporation are required for new commercial Eversource Customers
Type of Service Requested: (Circle Appropriate) Service Relocation em ovary Servic
New Service Service Upgrade r
Pole Relocation Disconnect/Reconnect Service Removal e e
OH Service from Pole, Pole#:UP no#across from UP 22/50 on S. Shore Drive UG Service from; Riser-Pole#:
Customer Loading Brief Description of Work
Temporary service for dewaterinq purposes for
Type of Load i__ New Connected Load in KVA
Town of Yarmouth Sewer Project.
__ Single Phase Three Phase
Lighting_ _..."
Electric heat _..____....____
Air Conditioning
Refrigeration
Cooking ______—
Electric Dryer .______
Water Heater
Computer
Process Equip. —.___ __.___
—Miscellaneous
<30 KvA _ ___.___
Miscellaneous , ,_-R,._- _--_-----
Totals <30 KvA -
Number of Meters Required: Commercial: 1 Public:
Residential: Amperage: 200 Phase: Sin le
Main Switch Voltage: 24_ —__ Amerae: 200 Phase: Sin le
Service Voltage: 240 Amperage:
Facility Type (i.e.: school, hospital): Outdoor Temporary Service New Building Square Feet: __________
If more than 1 meter is required, how will meters be labeled? (ie: Unit 1, 2, etc, Unit A, B, etc.)