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Home My WebLink AboutBLDE-22-003199 �. Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-003199 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:12/6/2021 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) 30 LEWIS RD Owner or Tenant Marcio Machado Telephone No. Owner's Address 30 LEWIS RD,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: Install one 240 V&one 120 V receptacle in laundry. 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 0 In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. TotaloNo.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: ADAIR MARTINS ELECTRICAN Licensee: Adair Martins Signature LIC.NO.: 55688 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:215 Palomino Drive, Barnstable Ma 02630 Alt.Tel.No.: 5088156173 *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 ( [( f 2., 6b:35t(A) totug ft 1416/" ice.,. `EC 0 3 2021 4. A� • ,j , '"` Commonwealth o� aedac�udattd Official Use Only it ;t cc�� n Permit No. Z��k�9 „w• r. spartmenf o`.}irs Serviced 11, ?i Occupancy and Fee Checked '_ ' c BOARD OF FIRE PREVENTION REGULATIONS6 [Rev. 1/07) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( EC),5 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ��j City or Town of: YARMOUTH To the Inspector of Woes: By this application the undersigned gives notice of his or h intention to perform the electrical work described below. Location(Street&Number) ' ti I , ; 1 ie fj Il 'm I`7 ' 0 _u Owner or Tenant M g-Cc/i 0 NAa GOP e7 Telephone No. Owner's Address Is this permit in conjuintion witi a building rmit? Yes ❑ No (Check Appropriate Box) Purpose of Building @S Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd El No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and V v`t 1 ell Na'i'tur I of Proposed VElectricalWork: n JGL 1i(,1 pe. 1 a46, tijur, Completion of the following table may be waived by the',vector of Wires. U. No.of Recessed Luminaires No.of Ceil:Sasp.(Paddle)Fans No.o{ Total ntTransformers KVA 't No.of Luminaire Outlets No.of Hot Tubs Generators KVA t 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 v ~= No.of Switches No.of Gas Burners 'No.of Detection and 1`, Initiating Devices No.of Ranges No.of Air Cond. ons! No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons IM No.of Self-Contained Totals: Detection/Alertinlevices No.of Dishwashers Space/Area HeatingMunicipal p KW Local 0 Connection 0 °der No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: 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 o El e trice!Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE GE: 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 pins and penalties o perjury,that the Information on this application is true and complete. FIRM NAME 'l-c/ r Max' ms 012- eJec f-> LIC.NO.: O-56 32-13 Licensee: 1 GIiir /lot, 1-0_S' TIliL Signature LIC.NO.: (If applicable, ter?gra"in the lic a numbe line.) Address: 1 5 /,J 1 N,e 144- 02655 Bus. el.No.: Tel.No.: *Per M.G.L.c. 147,s.57-61 I curity fork requires D partment of Public Safety"S"License: Alt.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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ I