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Home My WebLink AboutE-19-3362 Commonwealth of Official Use Only E !11 Massachusetts Permit No. BLDE-19-003362 • BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.I/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 ININK OR TYPE ALL INFORMATION) Date:12/4/2018 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) 20131 COLLEGE ST Owner or Tenant WOJCIK BARBARA L Telephone No. Owner's Address P 0 BOX 35, NORTH TRURO,MA 02652 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 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement furnace&add receptacle w/switch.(HOUSE#31) 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- I:1No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners 1 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 KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens 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: (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: Marcelo R Soares Licensee: Marcelo R Soares Signature LIC.NO.: 13036 (If applicable,enter"exempt"in the license number 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 NO4 12JCb e v, "moi lammonmsaS o j Met aehi.wlf, : official Use Only _»; Service! Q4-33(0Z �arLnw�o Permit No. • BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked a 'Rev. 1/0 APPLICATION FORtPERMIT TO PERFORM ELECTRICAL WORK All work to be performer in accordance with the Massachusetts Electrical Code(MET,527 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIONDate: !2- U' )t o City or Town of: YARMOUTH To the Inspector of W res: By this application the pndersigned gives notice of his or her intention to perform the electrical work described below. . Location (Street&Number) -1) 1 Co LLE GL ST-. ' w t1 hV,q../Lv Vt,� Owner or Tenant ('A S 510 frE1 Tel No. , iti t , Owner's Address - ��3 ' Is this permit in conjunction with a buildingpermit? Yes ❑ No ® (Check Appropriate Box) Purpose of Build ng Utliity_Aathorizatioa Na Existing Service_ Amps / Volts Overhead ❑ Und gid❑ No.of Meters _ New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meter _ Number of Feeders and Ampadty • Il ZLp�ation and Nature of Proposed Electrical Work; F$ WI Rt1)_ w ItkcE � Fv¢NPCE kQp� N:nimbi:CI .ATS SwtTLli 1 7{8 Completion of thefoflowing_tab/e may be waived by the Inspector of Wirer. N 7 � LU o it i o.of Recessed No.of Ce>Z.�Sasp.(paddle)Fan Transformers Tota! 10 o.of Luminaire Outletsgyp' O No.of Hot Tubs Generators KVA W � o.of Luminaires Swimming Pool Above In- Na of Emergency Ltghung �� emd rod. Battery Units (+� m o.of Receptacle Outlets No.of OB Burners FIRE ALARMS INo.of Zones _ o.of Switches No.of Gas Burners No.of Detection and ' Initiating Device No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump I Number ITons IKW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Loaf Municipal Connection 0 other No.of Dryers Heating Appliances Kw Security Systems:" No.of Water No.of Devices or Equivalent No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent 'Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP J OTHER: Na of Devices or Equivalent lel Attach additional detail if derired or as required by the Inspector of Wires. >_ Estimated Value of Electrical Work Work to Start: (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion INSURANCE COVERAGE: Unless waived by the owner,do 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 11)c undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. S. terrify, ONE: INSURANCE Cal BOND 0 OTHER 0 (Specify;) I ter , under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: Mi,4-Cei-9 (L- SOMA �'IECMtC iit, J LIC.NO.: ('1197),6 3 Licensee: MMLC1- o So� Signature fr fljapplicable,enter"tempt"in the licenseenumber line) LIC.NO.: Addresr. Bus.Tel.Noa - GF31f J •Per M.G.L.c. 147,s.57-61,securitywork requires Department of Public Alt Tel.No.: Safety"S"License: Lie.No. — Q 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 t Owner/Agent d Signature Telephone No. I PERMIT FEE: $