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HomeMy WebLinkAboutBLDE-22-003131 or .� \\ Commonwealth of Official Use Only fe� Massachusetts Permit No. BLDE-22-003131 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:12/1/2021 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) 14 COUNTRY CLUB DR Owner or Tenant Albert Mercado Telephone No. Owner's Address 14 COUNTRY CLUB DR, SOUTH YARMOUTH, MA 02664-2021 --,... Is this permit in conjunction with a building permit? Yes 0 No 0 (C ` :Box) /f O G Purpose of Building Utility Authori .tion , ,^ a Lng©(4M t Existing Service 100 Amps Volts Overhead 0 Und,rd lb' 0.4 ' ~li! New Service 200 Amps Volts Overhead ❑ Und. d 0 No . ' eters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service 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. 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. Tonal No.of Alerting Devices To No.of Waste Disposers Heat Pump Number Tons J KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 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:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Darnell Cauley Licensee: Darnell Cauley Signature LIC.NO.: 11662 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:54 CAPTAIN BESSE RD, S YARMOUTH MA 026642805 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: $50.00 t -17A- I Sfri te -- 615- cm) ,014 ., 47,,t-27, ,,,, s).2 Commonwaalth./MaeaarLea(ta Official Use Only al y t c� c� c ,I r- r 2epartmsni o`,} s' Permit No. E, ,'`' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] ((cave blank) CT o ' APPLICATION FOR PERMIT � , � a '1 All work to be TO PERFORM ELECTRICAL WORK performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 ' (,PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: if - , �- 9.1 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 Cr-;ri-11y C 1 Lib .1�r:.f e Owner or Tenant Abe- - /14-e t— cAZIO Telephone No. C Owner's Address �78' 70��73� Is this permit in conjunction with a building permit? Yes 0 No XI Purpose of Building c vil� (Check Appropriate Box) Utility Authorization No. 7 I I S 77 ct Existing Service l6O Amps l; /a4a Volts Overhead Undgrd❑ No.of Meters A__ New Service ,,9N1 t1, Amps I)O/ ,34)Volts Overhead Undgrd g 0 No.of Meters _i__ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: V 4 vi `j° Completion of the followingtable me,be waived by the In ector of Wires. ti.! No.of Recessed LuminairesNo.of 0/ No.of Cell.-Sasp.(Paddle)Fans Total �t No.of Luminaire Outlets Transformers KVA C\ No.of Hot Tubs Generators KVA ,t° 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 t` No.of Ranges Initiating Devices g No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers treat Pump Number Tons 1 KW °No.of Self-Contained Totals:l Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection 0 Other No.of Dryers Heating Appliances Kam, Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring; OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: i (When required by municipal policy.) Work to Stan: j i(9 g-91 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 BOND 0 OTHER 0 (Specify:) I certify,under th ains and e algq of perjury, er u that the Information on this application is true and complete. FIRM NAME: ar'nei, ley Licensee: � �� LIC.NO.: Signature LIC.NO.: ii4__za (If applicable,enter"exempt":in the li e numberiine.) Address: 541 Gj n Sx_ '"�' 4� Bus.Tel.No. tn M'¢ 1 Alt.Tel.No.: '174- __5% *Per M.G.L.c. 147,s.57451,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 a,ent. Owner/Agent Signature Telephone No. PERMIT FEE:$