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Home My WebLink AboutBLDE-22-005153 Commonwealth of Official Use Only to I to vMassachusetts Permit No. BLDE-22-005153 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 1Rev.1/071 ,- 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:3/16/2022 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) 265 NORTH MAIN ST Owner or Tenant FAIRVIEW EXT CARE SERVICE INC Telephone No. Owner's Address PO BOX 2489,PITTSFIELD,MA 01201 Is this permit in conjunction with a building permit? Yes 0 No 0 (Checkriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd No rs New Service Amps Volts Overhead 0 Undgrd j Number of Feeders and Ampacity �-fr/'�J Location and Nature of Proposed Electrical Work: Replacement dryer �D �Completion of the following tabl7,0 ) spretor of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transforme4, /��\ KVA No.of Luminaire Outlets No.of Hot Tubs Generators �� KVA ' 14 No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency L grmd. 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 ❑ Municipal 0 Other: Connection No.of Dryers 1 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 ifdesired,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 ❑ BOND ❑ OTHER ❑ (Specify:) /certify,under the pains and penalties of perfury,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:$80.00 (commonwealth o/ 7fiajjachusetto Official Use Only ra — /, cc�� c7Permit No. 2-� ` 5 3 2 epartment o/.}ire Services •,MT-1---7 i% Occupancy and Fee Checked t BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) —yV y'y 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: March 16, 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) 265 North Main Street Owner or Tenant Fairview Ext Care Service Inc. Telephone No. 508-394-3514 Owner's Address 265 North Main Street, South Yarmouth, MA 02664 Is this permit in conjunction with a building permit? Yes [l No 7 (Check Appropriate Box) Purpose of Building Commercial Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd No. of Meters New Service Amps / Volts Overhead n Undgrd n No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Connect and re-feed replacement clothes dryer Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. Tot Trans formers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- El No. of Emergency Lighting 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. Initiating Devices Total 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 p Totals: Detection/Alerting Devices No. of Dishwashers Space/Area HeatingKW Local ❑ Municipal ❑ Other p 1 Connection No. of D ers Heating Appliances KW Security Systems:* ry 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: $800 (When required by municipal policy.) Work to Start: 3/17/22 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 El OTHER ❑ (Specify:) I certify, under the pains and penalties of perjwy, that the information n this plication 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.: 508400-8936 *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 PERMIT FEE: $ Signature Telephone No.