HomeMy WebLinkAboutBLDE-22-007356 Commonwealth of official Use Only
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s. Massachusetts Permit No. BLDE-22-007356
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:6/22/2022
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) 21 TURTLE COVE RD
Owner or Tenant Michael Grady Telephone No.
Owner's Address 21 TURTLE COVE ROAD, 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: Wiring for addition
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 —1
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 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. Total No.of Alerting Devices
Tons
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 0 Municipal
Connection
0 Other:
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 perjuty,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:53 FALMOUTH SANDWICH RD, MASHPEE MA 026494307 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: $75.00
(40 6/7,411
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RECEIVED
N 212022 ' "nw"a4 4 41a4ac Official Use Only
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G DEPqRTMENT ,entel.tire�ervicalPermit No. t�'�v l:`,r' Occupancy and Fee Checked
,_,,, - I 'E PREVENTION REGULATIONS , lro7� (leave blank)
APPLICATION FOR PERMIT TO PERFORM
MI work to be performed in accordance with the Massachusetts Code 04E9,ELECTR 12.00MR CAL WORK
c. (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 00 t 7,1 Z 7----
City or Town of: YARMOUTH To the Inspector ojW�es:
By this application the undersigned gives notice othis or her intention to perform the electrical work described below.
2 c�Location(Street&Number) 1 Tl g-rt e Co,'tiE lie)
Owner or Tenant M ru r A I=L ( A
Z;
9 Owner's Address 1-1 Telephone No. , - + 7j?)
Is this permit in conjunction with a building permit? Yes ❑ No
❑ (Check Appropriate Box)
0
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Undgrd iP'd 0 No.of Meters �f New Service Amps / Volts Overhead❑ Undgrd
Number of Feeders and Ampacity g 0 No.of Meters
Location and Nature of Proposed
posed Electrical Work: ibUCFt y FtnP,S‘4 Prk,r2rn 0(3
bf
1.6 ' Completion ol'the followis table mmt be waived by the/hector of Wires.
No.of Recessed Luminaires No.of Cell.-Snap.(Paddle)Fans No.of Total
No.of Luminahe OutletsTransformers KVq
No.of Hot Tubs Generators KVA
P
No.of Luminaires-47
Swimming ool Above ❑ In- Pio.of Emergency Lighting
grad. ❑ Battery Units
`I No.of Receptacle Outlets No.of 011 Burners
FIRE ALARMS JNo.of Zones
No.of Switches No.of Gas Burners -No.of Detection and
i�! No.of Ranges Total Initiating Devices
No.o1 Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW -No.of Self-Contained
Totals:I. --r _ _1:_" `.•'.. Detecdon/AlerthiiDevices
No.of Dishwashers Space/Area Heating KW Load❑ Municipal
No.of Dryers Hea Connection 0 OtherAppliances KW Security Systems:* .'
No.of Water ICW No.of No.of Devices or Equivalent
Heaters No.of Data W
Signs Ballasts No.of Deevices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP
Telecommunications Wiring:
OTHER: No.of Devices or EquiviOent
Estimated Value of Inert ical Work: Attach additional detail if desired,or as requiredby the Inspector of Wires.
Work to Start: � Zl (Whenrequired by municipal policy.)
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"completes{
undersigned certifies that such coverage is in force,and has exhibited proof of samtion"e to then or its substantialssuinequivalent. The
CHECK ONE: INSURANCE E BOND 0 OTHER permit issuing office.
I certify,under the pains and penalties o ❑Information
on of that the Information on this application is true and complete.
FIRM NAME: ,Q.Ce Q &- L1,�L
Licensee: _ Pre LIC.NO.: \�__
(ifapplicable,enter"exempt"in the license number Iran.) Signature__��--� r LIC.NO.: Z ei..
Address. Bus.TeL No. •6 5.72(i
*Per M.G.L.c. 147,s.57-61,security work requiresAlt.TeL No.:
License: Lic.No.
OWNER'S INSURANCE WAIVER: I am aware that hh Department �Public 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 a.ent.
S Owner/Agent�
Telephone No. PERMIT FEE:$