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Home My WebLink AboutBLDE-23-001197 OF.. . Commonwealth of Official Use Only A-. Massachusetts Permit No. BLDE-23-001197 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:9/5/2022 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) 296 STATION AVE Owner or Tenant DENNIS-YARMOUTH REG SCHOOL Telephone No. Owner's Address 210 STATION AVE, SOUTH YARMOUTH, MA 02664-3000 ^(� Ng Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate to t� 1 t' Purpose of Building Utility Authorization No. 10260593E),f__ Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters C Ce I V2/ New Service 60 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install service to"School Zone"signal(POLE 24/43) Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA 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 Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: ,Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 Signs 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: Joseph Bellofatto Licensee: Joseph Bellofatto Signature LIC.NO.: 17506 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 11 AUTUMN LN, NORWELL MA 020612503 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 ture Telephone No. PERMIT FEE: $80.00 tt,t,t ,_ al ‘174/ c -- .•••- u u \ Commonwealth of f a6��hu6ettb Official Use Only =.- 3 -- 19 7 ��= c� c7 Permit No. iJ .--_,,I— ; I1_ ? .2epartment ol,.y`ire Serviced 1_ .!I --II�_ 5 Occupancy and Fee Checked ,, �s' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) u cJ 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: 0 —,31)—(9- - City or Town of: 1 arm60th To the Inspector of Wires: Z By this application the undersign ves notice of his or her intention to perform the electri work described below. Location(Street&Number) -1-j Q , — PO 1 e c.LI /4" ; Owner or Tenant.lie yyni 5 ` f/Y1t111:-li R.A'CJ I 'is(kify)I S�i�Telephone No. Owner's Address a_L W 5 -,I) - 4 "o ern'-un I t OD-co (D Yes No Is this permit in conunction with a building permit?(�� c �� (Check Appropriate Box) Purpose of Building: v/It✓ 5]9 r!Q I Utility Authorization No. kg (pl)J , — Existing Service Amps / Volts Overhead n Undgrd n No.of Meters New Service ()(1 Amps Ideb /t Y 1olts Overhead Q} Undgrd n No.of Meters / Number of Feeders and Ampacity .6 /a)l/re_;7111 ! Location and Nature of Proposed Electrical Work: i" 0 CQ-- YIPS Sc6m 1 Zf e 4/ . Completion f the following table may be waived by the Inspector of Wires. C._, No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA v No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ 'o.of EmergencyUnits -Lighting grnd. grad. Batte 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: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW i Local❑ Municipal ❑ Other Connection 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 TelecommunicationsNofDeieorWiring:qal No.of Devices 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 cover a is in orce d has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCEBOND OTHER ❑ (Specify:) I certify,under t e pains and pewalties o erJury, that the information on this application is true and complete. /- FIRM NAME: 11 I I t7� /.r ( M /fi it- dim. /-YJ( ' LIC.NO.: /750(0A Licensee: Signature --_� LIC.NO.: (If applicable,ynier "exec pt"in thejf c_ej�se numt us.Tel.No.:7a/— 4l0-l0'/S� Address: / /nafe K� (� .)MOt / Alt.Tel.No.4017 15?-3 ia-`] *Per M.G.L. c. 147,s. 57-61,security work requir, 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 .J 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: $ , 01) ..._ ti