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Home My WebLink AboutBLDE-19-006234 • Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-006234 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•5/6/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 3 SHELBURNE RD Owner or Tenant PEREIRA MIGUEL Telephone No. Owner's Address PEREIRA TANIA,3 SHELBURNE RD,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace distribution panel. 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 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 ❑ 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 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:) certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LLOYD R SMITH Licensee: Lloyd R Smith Signature LIC.NO.: 15688 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 1ST ST, MELROSE MA 021764010 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 '14-_ l.ommonweatth 0//r/a�dac elh Official Uezo,se Only ' c� �i Permit No. ��-. M. .2 eparlmend o/Sire Serviced ,'I BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07J (leave blank) APPLIGATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:_ ,2,� 1 c) City or Town of: etitd01e.moi t.41 To the Inspe or f Wires: By this application the undersiggives no a of his or her intention to perform the electrical work described below. Location (Street&Number _,GE a f Owner or Tenant Awl/a- e/Le%. Telephone No. 7.7t/. S'77S ''(g Owner's Address 13,01E. AS ..../4300 f.- Is this permit in conjunction with a buildingpermit? Yes ❑ No (Check Appropriate Box) J Purpose of Building )l.A. iA Utility uthorization No. Existing Service Gb Amps )MD /a140 Volts Overhead Undgrd / l g ❑ No.of Meters -Nevi Service la) Amps 12V/ayo Volts Overhea Undgrd 0 No.of Meters /� 1 Nufnber of Feeders and Ampacity /7�^ Z,410y \ �..r Location and Nature of Proposed Electrical Work: , e I Y1 S ide `� i.) Completion o the followingtableby It �,,„; .c� r p f may be waived the InspNo.of ector 1 of Wires. 1 )b ,No`of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA -No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- 'No.or 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 No.of Waste Disposers • -seat Pump I Number [Tons KW No.of Self-Contained Totals:I �""" Detection/AlertinLDevices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ other • No.of Dryers Heating Appliances KW ' ecurity Systems:Connecti*on No.of Devices or Equivalent No.of Water Kam, 'No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP �l el No of Deviatio orsWiring:q No.of Devices Equivalent OTHER: NS Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: W — (When required by municipal policy.) _ Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERAGE: 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 Q " BOND 0 OTHER ❑ (Specify) I certify, under th'epains and penalties of erjury,that the information on this application is true and complete. FIRM NAME: i(iu i Souibt _ EURy4ER LIC.NO.: 14283.5 Licensee: LI PI Q. SGdM1 Signature�' ' C1 fv �.�_LIC. NO.: _g (If applicable enter'"exempt'"in the license number line.) Bus.Tel. No.: • t7-oZ30 Address: 024o CNf QT. , i , AAA UI`DiS Ltnik A Alt.Tel.No.:3 S-.241 I 'Per M G.L c 147, s. 37.61,security work requires Depa ent 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 required try 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: $ 6. ['