The URL can be used to link to this page

Home My WebLink AboutBLDE-22-006715 OR Commonwealth of Official Use Only fL Massachusetts Permit No. BLDE-22-006715 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:5/20/2022 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) 14 ARROWHEAD DR Owner or Tenant PIRES JOSIMARY F Telephone No. Owner's Address PO BOX 223, CHATHAM, MA 02633-0223 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 waste pump. 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 Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. rnd. 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 ❑ BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Italo Azevedo Signature LIC.NO.: 55518 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:41 South Main Street, Milford MA 01757 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: $75.00 1T241•66. 6 i s 737.74, 0,i.3_ /'C RECEIVED Y 19 2022 l.o uitonu ea&ol r//aaaachuestla Official Use Only :h .. c-� n '7 r v. .lJs�artnunf oi,} J Permit No. 1/7i 1{ _ u s srvase � a I N�� 2E PREVENTION REGULATIONS Occupancy and Fee Checked 3 _-__ [Rev. 1/07) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL blank) LECTRICA.0 WORK (� All work to be performed in accordance with the Massachusetts Electrical Code( EC),5 CMR 12.00 ' (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 5�10 aOr i —}, City or Town of: YARMOUTH To the Inspector Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. f9 Location(Street&Number) 1 it , EA0 r - Owner or Tenant —TO Si MPC (?�� Q t yam,., X o Telephone No. _$S—�'—'—�J Owner's Address ,� � Is this permit in conjunction with a building permit? yes Purpose of BuildingNO El (Check Appropriate Box) — iy_____ (� Utility Authorization No. Existing Service Iga. Amps sVolts Overhead'' Undgrd Nam,Service Amps El No.of Meters Amps / Volts Overhead❑ Undgrd❑ No.of Meters S Number of Feeders and Ampacity "'44 i Location and Nature of Proposed Electrical Work: �nj p , , t4 �iG 7 WQ 9( Vj, plf°l Corn letion o the ollowin table m be waived b the In ector o Wires. No.of Recessed Luminaires No.of Ceil.-Sas . p (Paddle)Fans Transformers ota �t No,of Luminaire Outlets No.of Hot Tubs KVA �`� Generators KVA t:' No.of Luminaires Swimming Pool °Ve ❑ n- o.o mergency g n rnd. d. ❑ Batte Units g ` No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.o etec on an t',c:; No.of Ranges Initiatin Devices No.of Air Cond. ota Tons No.of Alerting Devices eat ump um er ons o.o e - ont ne No.of Waste Disposers Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Cun c pa No.of Dryers Heating Appliances Kw ecti ty ystems on 0 �� o.o a er ° o No.of Devices or E uivalent Heaters K'W o.° Data Wiring: Si ns Ballasts No.of Devices or uivalent No.Hydromassage Bathtubs No.of Motors Total HP e ecommun ca ons r g OTHER: No.of Devices or E uivalent Estimated Value of lectr' at Work; y V Attach additional detail if desired,or as required by the Inspector of Wires. Worm Start (When required by municipal policy.) spections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 penalties of and I certify,under the0 (S� cify:) painsP f perjury,that the infi r 4 on on this application is true and complete. FIRM NAME: & _ Licensee: y. jA �j E V =•m• � LIC.NO.:� (If applicable,enter exempt in the license number line.) 5ignatu ��!rtr..Q�„si. LIC.NO.: •1 ! Address: Bus.Tel.No.. p �9 *Per M.G.L.c. 147,s.57-61,security work requires Department of Pu= `�� OWNER'S INSURANCE WAIVER: tam aware that the Licensee does not havehe liability Ail.Tel.No.: V required by law. BymysignatureLic.No. Owner/Agent below,I hereby waive this requirement. I am the(check on insurance coverage normally Signature owner •■ owner's a:ent. Telephone No. PERMIT FEE:$