HomeMy WebLinkAboutBLDE-21-003971 !.��`� ' 'v Commonwealth of Official Use Only
fi Massachusetts Permit No. BLDE-21-003971
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:1/19/2021
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) 308 ROUTE 6A
Owner or Tenant COSTELLO ROSALIND Telephone No. A
Owner's Address COSTELLO MARSHA A, 308 ROUTE 6A,YARMOUTH PORT, MA 02675
Is this permit in conjunction with a building permit? Yes 0 No 0 (Chec. •• iat• :+i
i* ‹f/
Purpose of Building Utility Authorization No.
3
Existing Service Amps Volts Overhead 0 Undgrd 0 No.o AAks
New Service Amps Volts Overhead 0 Undgrd 0 No.o'yi
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Remodel kitchen. VO ••
Completion of the following table may be waived b .• for of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of I' 1
:
Transformers A
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ElNo.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 0 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:)
I certify,under the pains and penalties ofperjury,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:30 Brewster Rd, Mashpee MA 026492920 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: $80.00
74\rerit 11- (Nb ie primer&u erg' !rte
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. -. = BOARD DF FIRE PREVENTION REGULATIONS Lam.]J177] 61,04
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
An to s=pabannol.in aoonolsreee we.I=Idesuiratlx Elentral.Cede nil.ro ChM MUD
. (PLi_PBINTININg 08TiPEALL INFO
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C5ty or TuwiL at 47,,'%", = I` To the r elf
By this & -•- zed= . •;� or iede�rato pea 'ae o}�iceiwpr cdIrN!4 below.
_(Street&Number) )O ) g1- FSA
Owoer or Tumid . 'jiSULl- Ta "e Nd qcti'Va.- ( C-
-Owen`s A :urea •
Is aka perms its eaaProthou.was.a bonleterpersoir Yes 0 No 0 (Cheek.A.pprolairdz Bat)
l'orproe afB, € • Utf i'dy lam No.
A / Venda Ovedorad 0 tisagrd.0 No.of What
ire servirr Amps / Volts Dverlie;rd 0 Usecrd.0 No.of Motors
-- .. . ._iViiiiher—Vmhodunx znaligpidly
Lia oad.Nob=of Proposed E7edmL Watt pct-ru raJ n�—
Compinfoon of tire fnlkownlide awry in waned by dm
; n.of Total
Nn.of Renessed Taanv,wires No.ed CELSaep.(Piddle)Fos Trachoma= KPI
No,of T awmrair*Duds No.of Sot Tabs Gear •\
• Nn
DIT bk-
Nino :bur pnol as ❑ reu - ❑ig y= R - -. ! \
Nn.of Reesptarle Coeds Na.of Oriltorskeis FIRE ALARMS IN, of ., - C. A.
Net of lames ,No.of ems Soameeo; din aFDe am j, /1.,
Na r No.of Air Cra d. Total
No.of A ng •-,,;"--cC� Q B., 1
- • Nn ofWssdzDizpea+rss S�P Nemh' Toes KW *Nn.rd ''.- -„ - ��<pitic IP/
Na of Outer ElparedArea Resfoeg KW IotE1 0 141264,1 ❑ a ;- a`!
t
Na.of D ryerm Vis:AppEzones KWIgartYin.id as ., 1
No.of Wirt No.of Na.of Baia p+n
His KW
limns Bola& No.of De lees or . , _ ,
Nn Etydrorasecare 8a r4whs Na of Motors Total xr No.of Deriees or ; • ,;
O .
„Aarramiclitimnal ddafl rdai*ar m roindred by de nr ofiFirs
Esfordzsi Valise afElectical Wale (nem rewired.by radricipal play) '
Work to start
of i 5 J 21 is be in MFC Rale 1.0,aad.npao rm.
INSURANCE E CO Unless vainest by the ovine;,no p 'Sa'the pratuausocc of opens wort may imam;unless
1he limens provides paved of 9 inns `oricapletrsi apoodiarr econraCe or its 1 equivalent_ Ile
tedersigned eek that moth sewage is iafaroe,and has ertallified proof of some to the pooh issuing af&e. -
CEIBCE OATS: Mt/ ANCE 0 BD1*ID 0 oT ❑ (Speer.)
I=tip,aide the palm a iiipewit=ofpmrjary by at tie imformaficin on.altaa trim and iso
SNA: 4 A-Rca o IL- M4,-S tc�c 1i uc xn_ 0)0/76- b
Liceesee: s; rLIC.NO_ 2ZC�Rg-Il
Wr ti_L_e,ams"conein Be bee=namber ten Bae.Tea.No.:4- t-'f/ v-(0t1/79*
Alidrere. • ?1/49PC."---"
Alt TeL No.:
*he hi-G.I.L.r.. 147,a.57-61,mtorky wait requires Diepartioret af'Pablic SAY`>'Lim Lit.Na.
. OWIClCE-'S INS& ANC3 WAIPVCE: I am aware that the Lim=Ti. ' doer not hare the liability Onararocr.corverap=illy
wed by law. By my migmaL below,I booby waive tis necioireinost I am the(dusk ooe)0 owner 0 awns s a
Telephant Na. P' FEE' $
>yx.� „�; fir: