Loading...
HomeMy WebLinkAboutBLDE-22-004714 `es,... f,- ilt Commonwealth of Official Use Only f` *- fir ��V Massachusetts Permit No. BLDE-22-004714 I. 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•2/25/2022 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) 42 EARLY RED BERRY LN Owner or Tenant IACOZZI CLAUDIA Telephone No. Owner's Address 2 SEAN DR, MANSFIELD, MA 02048 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Purpose of Building Appropriate Box) Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity • Location and Nature of Proposed Electrical Work: Addition, upgrade service ', &smoke detectors. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 24 No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators 1 KVA No.of Luminaires Swimming Pool g bond.ve ❑ Prig'. ❑ No,of Emergency Lighting r Battery Units No.of Receptacle Outlets 30 No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches 12 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ton No.of Waste Disposers Heat Pump I Number I Tons KW No.of Self-Contained Totals: Detection/Alertine Devices 6 No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent KW No.of No.of Ballasts Data Wiring: Heaters Siens 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:) !0 Li I certify,under the pains and penalties of perjury,that the information on this application is true and complete. O�t- �� FIRM NAME: Simon P Roderiques Licensee: Simon P Roderiques Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 18233 Address:48 FERN ST, NEW BEDFORD MA 027442115 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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. II PERMIT FEE:$75.00 C6(-1-64.0s--If ( �j %"' I�( (("/6 /JL rnd-01jL.4 �fit.�� ��6�-ram 1 .� factrizr '/7/ leg (w'iu f,' /sty0 rSez- Ah,izaD) C to "P ec, c .� ;r 2-`3(- 4 t RECEIVED FEB 2 /, ' contntonwsa o! aasacaueelta a q Official Use Only �,_ 1; 25s Permit No. v 71 BUILDING DE r ol� Serviced BY: ,l V -- BOARD' OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked APPLICATION FOR PERMIT TO PERFORM Rev. Iro7) leave blank �— All work to be RM ELECTRICAL WORK performed in accodaace with the Massachusetts Electrical Code(MEC),527 CMR 12.00 'PLEASE PRINT IN INK OR TYPE ALL INFORM4770N) City or Town of: YARMOUTHDate: y this application the undersigned gives notice of his or er iattention toTo the Inspector of Wires: Location(Street&Number) L perform the electrical work described below. Owner or Tenant Owner's Address IaUd t Q Z'g� t�qh �� / qr Telephone No. Is this permit in conjunction with a b Ida nc permit? rmit. Yes No ❑ (Check Appropriate Box) purpose of Building g,L p� Utility Authorization No. xisthng Service / _ Amps J /aYd tilezagfteaQv Vohs Overhead Er... Undgrd 0 No.of Meters Amps d© la Volts Number of Feeders and Ampad�, — Overhead[ Undgrd 0 No.of Meters oo Location and Nature of Proposed3 Electrical Work: ,r! 0 P al — ray i / J all AO ea i j Com.letion o the ollowin:table m be waived b the In .r Ui No.of Retied Luminaires if No.of Ceil.-Susp. p,o o�tor o Wires. et No.of (Paddle)Fans Transformers ,� Luminaire Outlets No.of Hot Tubs KVA No.of Luminaires Generators KVA /� Swimming Pool d.e ❑ n- o.o 'mergen ' , '` No.of Receptacle Outlets d• ❑ Batts Uuits 'fig ` ,�Q No.of Oft Burners No.of Switches / a No.of Gas Burners. `o.o t tee, No.of Zones I,k.r o.of Ranges On an No.of Air Cond. o Inidatin Devices o.of WasteTons No.of AlertingDevices Disposers ,eat 'amsp .'um er oas ' `o.o No.of Dishwashers oat a C DetectioNAlertiu Devices Space/Area Heating KW l o.of Dryers Heating Appliances Local Connection 0 Other 'o.o " rKW ty ystems: Heaters KW o.o .o.o No.of Devices or ' ,uivalent S 's , Ballasts Data Wiring: Na.Hydromaasage Bathtubs No.of Motors No.of Devices or E,uivalent Total HP a ecommu a ons `} gg OTHER: No.of Devices or ' .uivalent j Q dQ,c�l Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Wotic:L �o2 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 the',licensee provides proof of liability insurance includingpermit for the Performance r itssubselectrical work may issuent. unless undersignedcertifies that such cov has op Lion coverage r substantial equivalent. The e is in force,and exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE I cart!,ff��under the pains and���� 0 OTHER 0 (Specify:) • FIRM NAME: /o t/ Pesjary,that the inforinatlon on this application is true and canrplete L /r!G li Licensee: o C / e_e Si LIC.NO.;-�----�-_-_.7 (Ifappikable,enter' gnature_ Address: Pt"In the/}c nu��llne.) /n� LIC.NO.: �a 3 *Per c. 147,s.57-61,security Ai /'°►f�i Qd se us.Tel.No.:_Tb�r'�o 4_9a3t7 *Per M.G.L.M ---------- OWNER'S INSURANCE WAIVER: work requires Department of Public Safety"S"License: Alt.TeL No.: IVER: I am aware that the Licensee does not have the liability insurance coverage normal! required by law. By my signature below,I hereby waive this requirement. I am the(check one owner ,Signature owner's a:ent. Telephone No. PERMIT FEE:$ s� .aO