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Home My WebLink AboutBLDE-22-003397 Commonwealth of Official Use Only i. Massachusetts Permit No. BLDE-22-003397 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:12/15/2021 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) 80 ROUTE 28 Owner or Tenant Grand Cafe Telephone No. Owner's Address 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: Upgrade lighting 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 36 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 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 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 perjury,that the information on this application is true and complete. FIRM NAME: EVANDRO SOUSA Licensee: EVANDRO SOUSA Signature LIC.NO.: 22277 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:202 N QUINSIGAMOND AVE, SHREWSBURY MA 01545 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: $80.00 RECEIVED DEC 13 2021 C 'nweati4oPiYamatiaue415 Official Use Only ''' if, �7 Permit No. ` J-`/ 7 I s adman/o`_}ira�tW{ceJ ` 6 'DING D E PA R T M E_ T Occupancy and Fee Checked '-• - ' PREVENTION REGULATIONS [Rev. 1/07] ram, (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 3 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: A I ( O 12) City or Town of: N U f \� /� �I t7 T(� W( /� 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) S ,i - - , e V' Owner or Tenant G R AN b c,Pt FE Telephone No.Se$29 2. S5 5 VI --/ Li) Owner's Address Is thispermit in conjunction with a buildingpermit? Yes j pe n No (Check Appropriate Box) Purpose of Building Wml; (,CA R 1_ Utility Authorization No. WExisting Service Amps / Volts Overhead n Undgrd I I No.of Meters (`7) New Service Amps / Volts Overhead C Undgrd C. No.of Meters 2 Number of Feeders and Ampacity 2 Location and Nature of Proposed Electrical Work: L1 h' 1 'i3 u p -c {e✓ '1'.) IA-b r, 11 C,0 r\rn NJ DM v) Completion of the following table may be waived by the Inspector of Wires. l l No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tr Tr of KVA Q No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires 6 Swimming Pool Above ❑ In- ❑ No.ofEmergency 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 t No.of Ranges No.of Air C'ond. Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons KW No.of Self-Contained Totals:I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Ilydromassage 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: . A1013. JO (When required by municipal policy.) Work to Start: 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 Et BOND ❑ OTHER ❑ (Specify:) I certify,under the ins and penalties of perjury,that the information on this application is true and complete. FIRM NAME: 0>US A I e—cir1 LIC.NO.: ,2.22-3 Licensee: 1 ) SOU A Signature } LIC.NO.: ZSj q I (lfapplicable, ter"�pt'•in the license number lin�._)/ Bus.Tel.No.•9 O IjSC Address: a t"L p Q1\J(4 f C V] 4 Yf(.Z )30 QA3U -1 l ft 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. 1 am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ L.6(.