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Home My WebLink AboutBLDE-18-002751a Commonwealth of Official Use Only Massachusetts Permit No. BLDE-18-002751 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ev.l/0 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 ININK OR TYPE ALL INFORMATION) Date: 11/`7/2017 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice or his or net intention o perform e e ectrical w rk described bell]ow�A Location (Street & Number) 29 NIGHTINGALE DR �% (-/V Q 1A Owner or Tenant OBRIEN LAWRENCE F Telephone No. Owner's Address 29 NIGHTINGALE DR, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit' Yes ❑ No ❑ (Check Appropriate Bos) 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 Am parity Location and Nature of Proposed Electrical Work: Wiring for basement exercise & family rooms. 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. grnd. rnd. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Cas Burners No. of Detection and Initiatine Devices No. of Ranges No. of Air Cond. Total No. of Alerting Devices No. of Waste Disposers [feat Pump Totals: Number I To;!'ni KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Muniicipal ection ❑ Other: ConNo. of Dryers heating Appliances KW necuriSvstems:o. of DWices or E iv 1 n No. of Water KW Iffenten No. of No. of ISionill Data Wiring: vices or Eiruivalent No. Hydromassage Bathtubs No. of Motors Total IIP Telecommunications Wiring: f 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 ❑ BOND ❑ OTHER ❑ (Specify:) f certify, ander the pains and penaldes ofperjury, that the information on this application is true and complete. FIRM NAME: Marcelo R Soares Licensee: Marcelo R Soares Signature LIC. NO.: 13036 (If applicable, enter "exempt' in the license member line.) Bus. Tel. No.: Address: 53 FALMOUTH SANDWICH RD, MASHPEE MA 026494307 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 signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. IPERMITFEE. $75.00 goo Commorru of /i/¢,iar effi ('.meq gal Use oni Permit No. \ c o cr�iad en hecked BOARD OF FIRE PREVENTION REGULATIONS ey1/073 ' dFceCnk) cave blank) -- APPLICATION FORIPLRMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance wit the MnsachuscM Etcctrical Codc (MEC), 527 CMR 12.00 TLEASEPFINTNXK OR TYPEALL INFORbti mAq Date: -I 1 1-1 City or Town of: OU 11 To thelnrpector of TVires: By this application the \orders fined pvesp1.o��ce of las or her intention to perform the electrical wort: described below. Location (Street & Number) a r u1TiNC,g1� 7Q aJOV>kl Own er 'or Tenant yeti' UUT•\-E �N�GEUVA-JE 96\1A Telephone No.lYile�orj� Owner's Address Is this Permit in conjunction with a building permit? YesNo ❑ (CheckAppropristeBox) Purpose of Eur7dtng Utility Authorization No. Existing Service t— -- I - SPs --.L.—Volts Overhead ❑ Undgrd ❑ No, of Meters _ fyd j New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters jy N .. umber of Feeders and Ampadty ocation and Nature_ of Proposed Electrical Wark^. ROUE �l -f SIN lS N �{t-Sr 04=nIC t r O Co tetian ofthe TOlfowin?tablem be waived by the lrupe4ar ofRiru, Recess^_d LuminairesNa. of Ceil-S °• °f usp. (Paddle) ) Fans Total • _--- --a-' , i Transformers KVA NO. of Lumiaafre Outlet INo. of Hot Tubs Generators KVA No, of Luminaires 1swionming pool Above ❑ _ a, of Lmergeacy Pnung erttd. Brad. ❑ IEattery Unfts No. of Receptacle Outlets No, of Oil Burners FIRE A.I..41tMS No. of Zones No, of Switches INo. of Gas Earners o. of Detection an Initiating Devices No. of Ranges No. of Air Cond. Togs No. of Alerting Devices No. of Waste Disposers eat ump umber Tons o. of etf ontaia Totals: Detection/Alerting Devices No, at Dishwashers Spaeez(Arm Heating KW' Local Municipal Conn an ❑ �� No. of Dryers Heating Appliances KW ecurity Spstems:� 0.0 ater No. of Devices or Equivalent Heaters KW o, Si o. o Data Mr-mg: Signs Ballasts No of Devices or E uivalent No. Hydromassage Bathtubs No, of Motors Total HP Telecommunicationswiring: Na of Detlees oruivalent OTHER Aaach addinana( detail if desire4 or errrequired by Ile Inspector of mjret. Estimated Value of Electrical Word (When required by municipal policy.) Work to Start Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COUnless 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 eq rivalcnt it a undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE E BOND ❑ OTHER ❑ (Specify:) I certify, rtnder the pains and penalties of perjury, thin the informviion on this application is true «rid eotnplete FIRM NAME: 1nA(LCr� (t, SDglLrs .6l cTiLtCIA-t'l LIC.NO.: PirJ�j(o-b Licensee: LAA-ace-Lo acense=m Signature IC. NO.: (Ifappfimble, enter "¢em to the license number fine.) Address-. %i0 CIfLL1n �(�fL (LTj �SI� I✓A t Bus. Tel. J 'Per M.G.L. C. 147, s. 57-61, secure work re Aft Tel. No.: ry quires 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 ByS required by law. By my signature below, I hereby waive this requirement I am the (cheek one ❑owner o t Owner/Agent ❑ wner's a ML Signature Telephone No.PERMIT FEE: S