HomeMy WebLinkAboutBLDE-23-003704 Commonwealth of Official Use Only
8E_ ,,� Massachusetts Permit No. BLDE-23-003704
F� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
(Rev.1/07j
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:1/9/2023
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) 1105 ROUTE 28
Owner or Tenant CAPE DELI FOODS INC Telephone No.
Owner's Address 1105 ROUTE 28,SOUTH YARMOUTH,MA 02664-4457
Is this permit in conjunction with a building permit? Yes❑ No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No. '
Existing Service Amps Volts Overhead ❑ Undgrd 0 iNzt,of Meters
New Service Amps volts Overhead 0 Undgrd 0 'f gters
Number of Feeders and Ampacity /" /vim/Al
Location and Nature of Proposed Electrical Work: Upgrade lighting / ,'^Vf
C5
Completion of the following t Oe for of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of tal
Transformers �[//��7 A
No.of Luminaire Outlets No.of Hot Tubs Generators \7 4!�A
No.of Luminaires 10 Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grndv. 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
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other:
Connection
No.of Dryers Heating Appliances KIA Security Systems:"
No.of Devices or Equivalent
No.of Water KW No.of No.of Ballasts 2 Data Wiring:
Heaters Signs No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total IIP 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: THIELSCH ENGINEERING INC
Licensee: RALPH A CARROCCIO Signature LIC.NO.: 16657
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:1341 ELMWOOD AVE,CRANSTON RI 02910 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 ❑owner's agent.
Owner/Agent
Signature Telephone No. 'PERMIT FEE:$80.00
E C. - AAItNE //�� pp,, Official Use Only
g= D Commonwealth- o f maoacIiuetto
= t cc�� Permit No. 2 '3 70
' -_ °Department o f ire Service-4 —
Occupancy and Fee Checked
''fir_—� : OARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank
BUILDING DEP• ENT
By: - - ' ATION 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: 12/28/2022
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) 1105 Main St.
Owner or Tenant Cape Deli Foods Inc. dba Picadilly Cafe Contact: Ed Telephone No. 508-394-9018
Owner's Address Same
Is this permit in conjunction with a building permit? Yes No l�l (Check Appropriate Box)
Purpose of Building Commercial 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: Replace lighting with energy efficient fixtures - 10 int. fixtures
47520 pdavey@riseengineering.com and 2 relamp reballasts.
Completion of the following table may be waived by the Inspector of Wires.
No. Total
No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans TransfKVAormers
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 Detection and
No. of Switches No. of Gas Burners 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
No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other
Connection
AppliancesKW
No. of Dryers Heating 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: $2,700.00 (When required by municipal policy.)
Work to Start: 1/2023 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 El (Specify:) t.y w-ather & Shepley Ins. 1/23
I certify, under the pains and penalties of perjury, that the information ' 1 s -• ca '' is true and complete.
FIRM NAME: Thielsch En.ineerin• LIC. NO.:
Licensee: Ralph Carroccio Signature �� LIC. NO.: 16657A
(If applicable, enter "exempt" in the license number line.) `j- ; , • No.: 401-784-3700
Address: 1:341 Elmwood Ave., Cranston, KI U291 U Alt. Tel. No.: 800-422-5365
*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: $ 80.00
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