The URL can be used to link to this page

Home My WebLink AboutBLDE-22-001172 ti�.�Qj Commonwealth of Official Use Only - 1 Massachusetts Permit No. BLDE-22-001172 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:9/1/2021 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) 2 CONSTANCE AVE Owner or Tenant CARDOSO OCTAVIO Telephone No. Owner's Address CRUZ-CARDOSO SHEILA M, 2 CONSTANCE AVE,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 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. 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 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. To No.of Alerting Devices 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 Ballasts Data Wiring: Heaters Signs 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 perjuty,that the information on this application is true and complete. FIRM NAME: Licensee: Matthew Gordon Signature LIC.NO.: 55830 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:22 Station Avenue, South Yarmouth Ma 02664 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 my 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 q A tit 011,7 (QI 354 OM) RECEIVED I ' AUG 31 2021 �f �' Ce 'nuiea&.ofc7Maeenachissetfa Official Use Only : `'.1 tJ 6 u E PA R l Ni E I�e el giro-Cervices Permit No. (%Z�� - •[J f ancy and Fee Checked J BOARD OF FIRE PREVENTION REGULATIONS [Rev.Occu1/p07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perfonned in accordance with the Massachusetts Electrical Code( ),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: K /31//2 1 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigne4gives notice of his or her intenfiorerfonn the electrical work described below. Location(Street&Number)// I Co5u !7<' Ave_ A Owner or Tenant , !'1 e/1t3 (grei t]7 Di Telephone No. i Owner's Address Is this permit in conjunction with a building permit? Yes 0 No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service - mps_„ / Volts Overhead Un o.of Meters New Service Amps Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity n Location and Nature f Proposed Electrical Work: r ;re - vI f N 4(-e c rt 4 re.p/Ot c,L �e, b(f:c\4e.< w i-rii 1 C b reel` c r- Completion of the followinktable may be waived by the Inspector of Wires. l No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Trani Toil / Transformers KVA C! No.of Luminaire Outlets No.of Hot Tubs Generators KVA r1 No.of Luminaires Swimmin Pool Above In- No.of Emergency Lighting g grnd. grad. ❑ 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 v. Tot 11.1 No.of Ranges No.of Mr Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons.. KW No.of Self-Contained Totals: 'MM _Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 Municip Connection ElNo.of Dryers Heating Appliances KW No.Security Devices or Equivalent No.of Water , Heaters Signs Ballasts No.of No.of Data Wiring: No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - No.of Devices or Equivalent OTHER: el �- Attach additional detail if desired,or as required by the inspector of Wires. Estimated Value of Electrical Work: 3 `7 (When required by municipal policy.) Work to Start: 'g7/3O/a I Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 0 OTHER ❑ (Specify:) I certify,under th''e�°°ins-aajn,_ Ren es of petjury,that a information on this application is true and complete FIRM NAME: v"!�'?//7 l� e i4/ -4 nrctr,in LIC.NO.:53-9 i r,�(�j� Licensee:`," ?7 (', ao fc y Signature aliiaLIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: *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 0 owner's agent. Owner/Agent I Signature Telephone No. ( PERMIT FEE:$