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HomeMy WebLinkAboutBLDE-22-006555 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-006555 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:5/16/2022 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) 1070&1074 ROUTE 28 Owner or Tenant Paul Marchione Telephone No. Owner's Address 1076 Route 28, 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 ❑ 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: Miscellaneous work •er attache, x,7 :} 1 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 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 Gas Burners No.of Detection and No.of Switches Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices al Munici No.of Dishwashers Space/Area Heating KW Local 0 Connection ❑ Other: HeatingAppliances KW of Dryers PP W 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 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Arthur D Martinez LIC.NO.: 10653 Licensee: Arthur D Martinez Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: o. Address: PO BOX 455, NORTH TRURO MA 026520455 *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. I PERMIT FEE: $100.00 �-,- RECEIVED ` RECEIVED MAY 122022 J; �Of eld Use Ally MAY0 BUILD! Permit No. �Occupancy and Fee Checked BUILDING DE'N._�•. NT : •ARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) BY: ---- *eve blank) c, ' . ATION FOR PERMIT TO PERFORM ELECTRICAL WORK `' NI work to be performed la accadwice with the Mwdhusetts Electrical Cade(MEC).527 CM 12.00 (PLEASE PRIM IN INK OR TYPE ALL INFORMATION) Rate: b/67 a©cad City or Tows of:,�, .,ii► kilt.I'111 L'i iq i i To the Inspector of Wires: By this application the undersigned gives notice of bis or her iatention to perform the electrical work described below. Location(Street& umber) 11 7(, (l,,L4f T� Owner or TAW Hill I HUJ(A 1 nine Telephone N..g73 371'O JJ', Owner's Address '1 li y r-1 el ,jj_VfLondi.l.-t 1 1 1Is this permit la conjunction with a bonding persslt? Yes 0 No Er (Cheek Appropriate Rai) P.rpsse of R.■dt.g kestr4 u.ran L-t- Utility Authorisation Nor. 1 Existing Service Amps / Vela Overhead❑ U.dgrd 0 No.of Meters }i Amin Am / Volt Overhead❑ U.dard❑ No.of Meters _�..r Number of Feeders sad Ampsdty c G Location and Nature of Proposed EleetrIad Work: . t 3CA Aloe 04}iE f f' coetti e_, G:II Irh t cutltl- enter iv I ale,: �� Cambrian of the/6Jb+rA�raAk orq be rwn,na by the rMr 9I wjnQ- 'ill o[ T 'w No..f Recessed L.asinalns No.ofG4B.sp.(Peddle)Fano Triiosfsr.rers KVA ,L No.of Lshalre Outlets No.of Het Tubs Geoeratora KVA 6 4 Na of Lrmis.lns Pod Above ID- Peon sr EmsZe.eir Wong 6wimml.p :wad. ❑ gad. ❑ sawn mats No.Our Re de Outlets No.of ON Burners nu ALARMS JMa of Zits No.of Swltehss No.of Gas B.r.en Wtiodn D Ala of sues tlaq.t Devisors No of Roves No.of Air Co.L Total ens No.of Alerting Devices No.d Waste Disposers TooshuI N.oke�.T1'..„NW.__:.'N yackG.td.ed viete Na of Dlskwasbers Space/Area Heating KW Loral❑ j 'Odlr No.if Dryers Heating Appliances KW a No.of Devices sr gooh.lat Tee.d Water KW 'No.of No.of _WWag; Heaters Ballasts Nor of or No.Hydroasasspe Bathtubs N..of Motors Tstai HP No.of Devices or E. : . OTHER: Aiwa*arMrlowml detail(ides rrd or as rev:deed by the Inspector of Wirer. Estimated value or Electrical Work: f% 6 0 pf (When required by municipal policy.) Work to Start 51 S f ci Inspections to be requested m accordance with MEC Rule 10.sod upon completion. INSURANCE COVERAGE: Unless waived by the owner,no path for the perfor nonce of electrical work may issue unless the Hcettsoe provides proof of liability insurance including"completed operation"covertly or its substantial egaivakm. The usdasigned certifies that ouch covenspe is in force.and has exhibited proof of some to the permit issuing office. CHECK ONE INSURANCE et BOND 0 OTHER 0 (Specify:) 1 eieffeb,a sdvr hepei,ss surd penal*:of perfory,that dor Farads.Our thk applko ro isaw and c.ypkor. rum NAME: C.,%)ntho ef 0 tAr it Ct. f LIC.NO.: 410663 Licensee:nsee: AP'N►u r M p,tie;h e L Sig.aturs LIC.NO.: (If cpplikabk.enter"esssypr"Ise the Herne / Bus.Tel.No.: 6ti r"k'7 if‘Itk Address: 7 OtS t r dt >fah s AIL Td.No.: COO- 404 at'St *Pee M.G.L.c. 147,s.57-61,security work requires Depertraeat of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not how the liability insurance coverage normally required by law. iljy ray ' below.I hereby waive this requirement lam or the(check e)El owner 0 owner's agent 5 peter 1 - Telephone No.q 7f,7 l70-69A PERMIT FEE:$ /lob..00