HomeMy WebLinkAboutBLDE-18-002623 Commonwealth of Official Use Only
` ' Massachusetts Permit No. BLDE-18-002623 •
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
)Rev.l/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:11/2/2017
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) 90!32 WILDWOOD PATH
Owner or Tenant FRANCA RODRIGO M Telephone No.
Owner's Address 30 WILDWOOD PATH,WEST YARMOUTH,MA 02673
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 ❑ 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: Replace meter bank.(UNIT#32)
Completion of the following tab �e the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total
Transformer./// 45 KVA
No.of Luminaire Outlets No.of Hot Tubs Generators 45 <;/QJ'J�i�(,A
No.of Luminaires Swimming Pool Above a In- ❑ No.of Emergency Lighti
'(/J/
grnd. grnd. Battery Units v 0 VVVO
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of ' s
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices D
No.of Ranges No.of Air Cond. .Total No.of Alerting Devices 7
o
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained CX„,
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 KV No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Ilydromassage Bathtubs No.of Motors Total IIP Telecommunications Wiring:
No.of Devices or Equivalent _
OTIIER:
Attach additional detail)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 ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application Is true and complete.
FIRM NAME: THOMAS P SULLIVAN
Licensee: Thomas P Sullivan Signature LIC.NO.: 18182
(If applicable,enter'exempt"in the license number line.) Bus.Tel.No.:
Address:71 WAQUOIT RD,COTUIT MA 026353517 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
SignatureurTelephone No. PERMIT FEE:$50.00
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l.ommonroea of Massachusetts ....C: y'O�ft�ieia se Only I �/l
fri )j \
/��� _ �_� 1JcparfmcnEol.Yir.Jcrvius Permit No. L'�' `/('JJ`C/i�fC�r/
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Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS fRev. 1/07) . (leave blank)
APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN MIK OR TYPE ALL DFORMATIOJ) Date: 1I — Z —1 7
City or Town of: YARMOUTH To the Inspector of Wires:
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. By this application the gndersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 3 '(/11/r/7//Ohe7.
OOwner•orTenant 4I-11/1 "F2 14 N Ca Telephone No.
Owner's Address —'
...\,..._..)
J Is this permit in conjunction with a building permit? Yes 0 No Q"' (Check Appropriate Box)
. Purpose of Building +Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd El No.of Meters _____
a\ New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters __
Number of Feeders and Ampacity T 1 ,t� 1 ,
LocationNature of Proposed Electrical Work: .P.l$LQ. 'C. girg 'C„r]ij �, .k ... .. .
` v Completion ofthe fa:lowirte table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Cet1-Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators • KVA
c \ No.of Luminaires Swimming Pool Am bole orad. Bae 0 In- 0 INottery U.of t',mergeucy l tghung
U nits
n , No.of Receptacle Outlets No.of Oil Burners IF132E ALARMS INo.of Zones
\` \J No.of Switches No.of Gas Burners No. ii DetectioninD and
\�.\J lnttiatine Devices
No.of Ranges INo of Air Cond. Ton No.of Alerting Devices
No,of Waste Disposers (Heat Pump I Number Irons I KW No,of Self-Contained
Totals: Detection/Alertino Devices
No.of Dishwashers • Space/Area Heating KW Local Municipal
Connection 0 other
\ No.of Dryers Heating Appliances Security Systems.`
No.of Water INo. of No.of Data°WirDevicesorEquivalent
Heaters Ballastse
U Sins No.of Devices or Equivalent
No.Hydromassage Bathtubs INo.of Motors Total HP Telecommunications Wiring:
\ No.of Devices or Equivalent _
e5 OTHER:
q Attach additional detail rderiretj or as required by the Inspector of Wirer.
1✓� Estimated Value of Electrical World ,,,:„ ..e?, ' (When required by municipal policy.)
(k
Work to Start// /- /7 Inspections to be requested in accordance with NEC 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
CAr-'-"' ►_ _tundersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
t— 4 CK ONE: INSURANCE 0'BOND ❑ OTHER
NICs E , under the .. . 0 (Specify.)
h , d pennrAas of.erj 1 that ihe4tforrnatio � ''.n is true and corn fere.
.....I JAI NAME: l/ i C�s //� LIC NO.:��1
ti! 0 I - N�
U ? 1Litensee: d / Signatu��� W LIC.NO.:
O (I/applicable.enter"exempt' in the license numb. fin ) 'Bus.TeL No.: . I"Piar� /
l,ld Z ' Cele/ /
Address G!/ ' � ( ,., 4 Alt Tel.No.r S_ W V
la:
Q
(__, 117 Ter M.G.L.c. 147,s.57-61,security work requires Dep .. ent of Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER I am aware th- the Licensee does not have the liability insurance coverage normally
requir
S Ownerd/by law. By my signature below,I hereby • ve this requirement I am the(check one)0 owner 0 owner's agent.
d Signature Telephone No. I PERMIT FEE: $ 1