HomeMy WebLinkAboutBLDE-21-005097 Commonwealth of Official Use Only
inMassachusettsPermit No. BLDE-21-005097
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:3/9/2021
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below.
Location(Street&Number) 451 FOREST RD
Owner or Tenant TOWN OF`YA 'AV UTH Telephone No.
Owner's Address WATER DEPT, 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463
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 CI Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Renovations tt,, tro1p Station#10
Completion of the following table may be waived by the Inspector of Wires.
No.of Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA
No.of Luminaire Outlets
No.of Hot Tubs Generators KVA
SwimmingPool Above ❑ In- ElNo.of Emergency Lighting
No.of Luminaires 5 grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Detection and
No.of Switches No.of Gas Burners Initiating Devices
No.of Air Cond. Total No.of Alerting Devices
No.of Ranges Tons
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers Totals: Detection/Alerting Devices
al Munici
No.of Dishwashers Space/Area Heating KW Local ❑ Connection 0
Other:
Security Systems:*
No.of Dryers Heating Appliances KWNo.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
KW Signs Ballasts No.of Devices or Equivalent
Heaters Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP 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: PAUL M MAGALHAES LIC.NO.: 16722
Licensee: Paul M Magalhaes Signature
Bus.Tel.No.:
(If applicable,enter"exempt"in the license number line.) Alt.Tel.No.:
Address: 10 CONDUIT ST,ACUSHNET MA 027432634
*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
signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent.
Owner/Agent I PERMIT FEE: $0.00
Signature Telephone No.
r ` r' 31N4(72
- Commonwealth o`Maddachudeltd Official Use Only
= ;!t C. J�c� �7 Permit No. — /
c 1= 2 epartment o�.}ire Serviced
_,1`_ Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07]
., (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
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 3/3/21
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) 451 Forest Road-Map Parcel 77.2
Owner or Tenant Yarmouth Water Department Telephone No.
Owner's Address 99 Buck Island Rd, West Yarmouth, MA 02673
Is this permit in conjunction with a building permit? Yes C No ❑ (Check Appropriate Box)
Purpose of Building Pump Stations(Municipal) Utility Authorization No.
Existing Service Amps — / Volts Overhead ❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Pump Stations#10- Demo old and replace with new:
lighting. Wire new unit heater using existing circuit.Wire new exhaust fans.
Completion of the followin&table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf T
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires 5 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 ❑ Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts 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 desirea or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 8,790 (When required by municipal policy.)
Work to Start:ASAP 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 ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: M-V ELECTRICAL CONTRACTORS, INC LIC.NO.: 16722
Licensee: Paul M. Magalhaes Signature LIC.NO.: 16722
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:508-995-3826
Address: 10 Conduit St.,Acushnet,MA 02743 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. I am the(check one)❑owner ❑owner's agent.
Owner/Agent PERMIT FEE: $ waived
Signature Telephone No.