HomeMy WebLinkAboutBLDE-23-000301 - Mattachese Commonwealth of Official Use Only
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Permit No. BLDE-23-000301
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:7/19/2022
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) 400 HIGGINS CROWELL RD
Owner or Tenant TOWN OF YARMOUTH Telephone No.
Owner's Address 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463
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 No.of Meters
New Service Amps Volts Overhead 0 Undgrd 0 o.of Meters
Number of Feeders and Ampacity Ot
Location and Nature of Proposed Electrical Work: Annual Maintenance Permit(Mattacheese Middle
Completion of the folio ' b e •ir 1 ector of Wires.
No.of y �,/IT.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans � ^..� �.° ;
p Transformers // ei
No.of Luminaire Outlets No.of Hot Tubs Generators / �" VA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting .(') r `
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
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: Russell E Mealey
Licensee: Russell E Mealey Signature LIC.NO.: 14020
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 10 SIGNE RD, DENNIS MA 026382411 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: $0.00
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MAINTENANCE DEPARTMENT
Dennis-Yarmouth Regional School District
296 Station Avenue
South Yarmouth,MA 02664
Telephone: 508.398.7670 Fax:508.398.7663
Sandra Cashen,Facilities Manager Steve Faucher,Assistant Facilities Manager
Cell 508.726.8161 Cell 508.889.8721
Date: 7/18/2022
To: Town of Yarmouth Electrical Inspector of Wires
From: Russell Mealey, Electrician License No.14020-8
Re: Request Annual Maintenance Permit
An electronic copy of all electrical work orders will sent monthly of each school to the Electrical Inspector for
review.
Request annual maintenance permit for July 1,2022 through June 30,2023 from the Town of Yarmouth
Electrical Inspector of Wires for the following facility.
Mattacheese Middle School
400 Higgins Crowell Road
W.Yarmouth,MA 02673
Phone: 508.778.7979
Fax: 508.778.7987
Map/Parcel P/0-64/36
Thank you,
cc: Carol Woodbury
Sandra Cashen
Russell Mealey
Electrical Inspector MMS.doc