HomeMy WebLinkAboutE-20-2306 fACommonwealth of Official Use Only
Permit No. BLDE-20-002306
Massachusetts
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•10/24/2019
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) 34 MARSH SIDE DR
Owner or Tenant PERKINS RICHARD A TRS Telephone No.
Owner's Address FISCHER PATRICIA L TRS,34 MARSH SIDE DR,YARMOUTH PORT, MA 02675
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: Install generator.
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 1 KVA 20
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 0 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 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 ❑ 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
gig (1
. RECEIVED
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`�P [ s Permit No.
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BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. i/07] (leave blank) --
w APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
\yyl �, (PLEASE PRINT IN WK OR TYPE ALL INFORMATIOA9 Date: i o/Z�
Cityor Town ` �-�
( of: YARMOUTH To the Inspector c-) Wires:
1 By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
v,
v Location(Street&Number) ', cf-rol.V5(j E D(L Y MO"(Jf I} j f-•r
Owner or Tenant *I Cl.} .(L) p�16-1105
N f
c7 Telephone No. _ ���
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No
. ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead ❑. Und d
l;T ❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: aO �w Cet
a°oA-S 5 I� vrtk
Completion of thefollowin- table may be waived by the Inspector of Wires.
No. of Recessed Luminaires Na of Cet1-Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA r
• No.of Luminaires Swimming Pool Above ❑ In- No.of lr:mergency Lighting -
ernd.. acrid_ � Battery Units
No.of Receptacle Outlets No.of 0R1 Burners FIRE ALARMS JNo.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges Na of Air Cond. Total
Tons No,of Alerting Devices
No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area HeatingKW' Muni ' al
Local❑Connection
❑ Other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water No.of
Heaters ' No.of Data Wiring:
Ballasts
SignsNa of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: -
No.of Devices or Equivalent
O 11iL+R:
Attach additional detail tf desired 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,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 WI BOND ❑ OTHER 0 (Specify.)
I certrfy, under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: (Vi f-Cf L,) IC.- S,9 S &-(,h GNI.I t P
LIC.NO.: I"j77j,‘ ►-
Licensee: IA/l act Signature @ilk(If applicable,enter"erempt"in the license number line.) LIC.NO.: Z��
Address: Bus.Tel.No.: —6�,-z,4
J Per M.G.L. c. 147,s.57-61,securitywork Alt.TeL No.: //
requires 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
required by law. By my signature below,I hereby waive this requirement I am the(check one)❑owner ❑owner's agent
Owner/Agent
'l� Signature Telephone No. I PERMIT FEE: $ ,S l)