HomeMy WebLinkAboutBLDE-23-003394 Commonwealth of Official Use Only
/I' Permit No. BLDE-23-003394
i I. Massachusetts
I.
^�^�� 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) D a te:12/19/2022
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 (Checlt ��o'riat'�k)]
Purpose of Building Utility Authorization N
Existing Service Amps Volts Overhead 0 Undgrd
New Service Amps Volts Overhead 0 Undgrd , 1 1 kill.
Number of Feeders and Ampacity O8 t
Location and Nature of Proposed Electrical Work: Install receptacle and circuit. Install Cat6 for camera.
O
Completion of the following table may b ' v nspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle) Fans No.of Total
Transformers it)KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting
grnd. f rnd• 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. To
No.of Alerting Devices
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 0 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 Siens 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: REILLY ELECTRICAL CONTRACTORS
Licensee: Sean Reilly Signature LIC.NO.: 22960
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 14 Norfolk Avenue, Eastson MA 02375 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: $0.00
C I EJ I ,nwealth o/1addachccaetfa Official Use Only
*—=_
Permit No. /23-3 5 c7/
cc''��
=, DEC 1 4 2022 2-.-rtment o� ire.Serviced
Occupancy and Fee Checked
4 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank)
aUILDING uLI-'ARTMENT
- 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: 12/15/2022
City or Town of: South 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 Avenue
Owner or Tenant D-Y High School Telephone No. 508-398-7670
Owner's Address 296 Station Ave. -South Yarmouth, MA 02664
Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box)
Purpose of Building Educational Utility Authorization No. n/a
Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install duplex receptcale and associated branch wiring, new Cat6
Cable for Hudl camera installed by others.
Completion of the followin: table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil: p•(Paddle)Sus le Fans Tr of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above 1-1 In- ❑ No.of Emergency Lighting
g grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
of
No.of Switches No.of Gas Burners No. Initiatinnggon Dete and
In Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
g Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
p Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ Other
p Connection
No.of Dryers Heating Appliances NW Security'Systems:"
�Y No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaters KW Signs Ballasts No.of Devices or Equivalent
dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.H
Y g No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: $2500.00 (When required by municipal policy.)
Work to Start: 12/16/2022 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 ® BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information n this placation is true and complete
FIRM NAME: Reilly Electrical Contractors, Inc. LIC.NO.: 556 Al
Licensee: Sean Michael Reilly Signature LIC.NO.: 22960-A
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No..508-394-3211
Address: 14 Norfolk Avenue,Easton,MA 02375 Alt.Tel.No.:508-400-8936
*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
Signature Telephone No. PERMIT FEE: $
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