HomeMy WebLinkAboutBLDE-23-003806 Commonwealth of Official Use Only
Permit No. BLDE-23-003806
I , Massachusetts
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:1/13/2023
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) 94&98 STATION AVE
Owner or Tenant ROMN OATH BISHOP OF FALL RIVER Telephone No.
Owner's Address C/O ST PIUS X PARISH, CLARA ST, SOUTH YARMOUTH, MA 02664
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 0 Undgrd 0 Nq.'/o1VI�tRt
New Service Amps Volts Overhead 0 Undgrd 0 ',,1�fip,,of -!e
Number of Feeders and Ampacity ' ` , ,,,,1/` • ,) ,,
Location and Nature of Proposed Electrical Work: Install generator(5 Barbara Street) f j `'i , _
Completion of the following table may be iyel4k4.►+spgetilr of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total
Transformers ,r IcVA
No.of Luminaire Outlets No.of Hot Tubs Generators 1 :KVA 26
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
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices
Space/Area HeatingKW Local ❑ Municipal ❑ Other:
No.of Dishwashers P Connection
HeatingAppliances KW Security Systems:*
No.of Dryers PP No.of Devices or Equivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Siens No.of Devices or Equivalent
Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
required Value of Electrical Work: (When q uired by municipal policy.)
y'
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: Charles K Swanson LIC.NO.: 12895
Licensee: Charles K Swanson Signature
Bus.Tel.No.:
(If applicable,enter"exempt"in the license number line.) Alt.Tel.No.:
Address:718 CEDAR ST,W BARNSTABLE MA 026681300
*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 ❑ owner's agent. I
Owner/Agent 'PERMIT FEE: $80.00
Signature Telephone No.
Commonwealth o/Masiachuaetio Official Use Only
t = =P c� Permit No. 2-S '3J Ei 0-1.
c_-1�1—1 Thepartment o ire)ervicee
_l-t_ Occupancy and Fee Checked
=,:o BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07]
• _ (leave blank)
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: ►/q/23
City or Town of: \(acmoo,k1n 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) 5 Pj ark)cu o vicee*
Owner or Tenant '*, QiI,AS X ClntA.6A Telephone No. 5o%-3011:,-224g
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No K) (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: W;r,oQ 2(0 Kw j&\exa*oc
Completion of the following table may be waived by the Inspector of Wires.
g No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total
Transformers KVA
vv
No.of Luminaire Outlets No.of Hot Tubs Generators I KVA
. A)
.9 No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
—
Q1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
1 No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
Tota
L No.of Ranges No.of Air Cond. Tons 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❑ Monnectiunicipal ❑ Other
C on No.of Dryers Heating Appliances KW Security Systems:*
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: (150 (When required by municipal policy.)
Work to Start: i1 iii23 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 co rage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE gillBOND ❑ OTHER ❑ (Specify:)
I certify, under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: 11 obies Ntck-Vi € CooMnA / -LAIC.NO.:
Licensee: C\not\eS 1.. Swat\son Signature. !�" L, C.NO.: 128615 A
(If applicable, enter "exempt"in the license number line.) Bus.Tel.No.:50S-1-75-3083
Address: 2141 `(acrnow n id.l 41annis 024,0 t Alt.Tel.No.:
*Per M.G.L. c. 147,s. 57-61,security wdrk 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
PERMIT FEE: $
Signature Telephone No.