HomeMy WebLinkAboutBLDE-22-003448 a'' Commonwealth of Official Use Only
1 Permit No. BLDE-22-003448k` 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:12/17/2021
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) 176 SEAVIEW AVE
Owner or Tenant Gury Roy Telephone No.
Owner's Address 176 SEAVIEW AVE, SOUTH YARMOUTH, MA 02664
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: General lighting&receptacles.
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 9 No.of Ceil:Susp.(Paddle)Fans 3 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
grad. grnd. Battery Units
No.of Receptacle Outlets 18 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 14 No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Total
No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers 1 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 Ballasts Data Wiring:
Heaters Signs No.of Devices or Equivalent
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. 5r 70 e 3 .
FIRM NAME: Luciano B Miranda
Licensee: Luciano B Miranda Signature LIC.NO.: 53429
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 11 LEXINGTON ST, BELMONT MA 024785010 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 FE : $260.00
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11!==,-�l c� Permit No.
�_`:1eii. A 2epartment o ._tire Serviced
f`- J4.. Occupancy and Fee Checked
L 2 ': ^* Q.v. BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
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' ` L' PPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
4 t, All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
C, o ( ?L I ASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 11/12/21
r2 City or Town of: South Yarmouth To the Inspector of Wires:
:; t s application the undersigned gives notice of his or her intention to perform the electrical work described below.
__��Loca ion(Street&Number) B6 Seaview ave
Owner or Tenant 2y WmTelephone No.
nwne 's Address V
Q hi permit in conjunction with a building permit? Yes rX No ❑ (Check Appropriate Box)
LUJ wp a of Building Residential Utility Authorization No.
N H
N Ett rg Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters
WNA rvice Amps / Volts Overhead❑ Undgrd 111 No.of Meters
V V N(i nher of Feeders and Ampacity
W �p Laaat n and Nature of Proposed Electrical Work: General finish lighting and outlets
I5ft ..
`o A" Completion of the following table may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires 9 No.of Ceil.-Susp.(Paddle)Fans 3 Tf
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 18 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No. Initiatingof Deteon and
14 Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
g Tons
No.of Waste Disposers 1 Heat Pump Number Tons KW No.of Self-Contained
p Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ Other
1 p Connection _
No.of Dryers Heating Appliances KW Security Systems:*
�Y No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaters KW Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP
TelecommunicationsNofDeieor Equivalent
No.of Devices Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 3000 (When required by municipal policy.)
Work to Start: 11/12/21 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 ❑X BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: First Choice Electric LIC.NO.: 22797 74
Licensee: Luciano Miranda Signature odV(',r LIC.NO.: 53429 y
(If applicable,enter "exempt"in the license& € r line.) Bus.Tel.No.: 6174547132
Address: 33 Mill Pond Circle Milford Ma 01757 Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work 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 PERMIT FEE: $
Signature Telephone No.
et(. potw.x.a cecrRt&/(tc. 14/tgt :t:. cow,
Elliott, Ken
From: Luciano Miranda <mi=andaboston@icloud.com>
Sent: Wednesday, March 23, 2022 4:37 PM
To: Elliott, Ken
Cc: Iutimiranda@yahoo.com.br
Subject: Cancelation for Permite
Attention!:This email originates outside of the organization. Do not open attachments or click links unless you are sure
this email is from a known sender and you know the content is safe.Call the sender to verify if unsure.Otherwise delete
this email.
Hello I would like to cancel the permit over 176 Seaview Ave,South Yarmouth,Ma Thank you !
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