HomeMy WebLinkAboutBLDE-23-004911 Commonwealth of official Use Only
4 Massachusetts Permit No. BLDE-23-004911
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:3/7/2023
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) 4 RUNE STONE RD
Owner or Tenant SHEILA REILLY Telephone No.
Owner's Address 4 RUNE STONE ROAD, SOUTH YARMOUTH, MA 02664-1325
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: Install generator(Kohler 14 KW)
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 1 KVA 14
No.of Luminaires Swimming Pool Above ❑ In- ElNo.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
Heating Local ❑ Municipal No.of Dishwashers Space/Area KW Connection
0
Other:
HeatingAppliances KW Security Systems:*
No.of Dryers PP 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.
required bymunicipal policy.)
Estimated Value of Electrical Work: (Whenq P P y.
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: Marcelo R Soares LIC.NO.: 13036
Licensee: Marcelo R Soares Signature
Bus.Tel.No.:
(If applicable,enter"exempt"in the license number line.) Alt.Tel.No.:
Address:53 FALMOUTH SANDWICH RD, MASHPEE MA 026494307
*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 'PERMIT FEE: $75.00 I
Signature Telephone No.
c g 3b,(2,5 (. .
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Commonwealth of Massachusetts PermitNo.: z3�Official U O�1
-- 1 _'/ Department of Fire Services Occupancy and Fee Checked:
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
' '—', APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
City or Town of: YARMOUTH Date: 0-)7 i t14-11%,
To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): Li R I}N SYNC PO Unit No.:
Owner or Tenant: S l-h5l LA U-\ Email:
Owner's Address: Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes 0 No 0 Permit No.:
Purpose of Building: Utility Authorization No.:
Existing Service: Amps / Volts Overhead 0 Underground 0 No.of Meters:
New Service: Amps / Volts Overhead 0 Underground 0 No.of Meters:
Description of Proposed Electrical Installation: 14 c . c--i w t 1A4 1(OF � -' 1L
SWA'IZ Yr
Completion of the following table may be waived by the Inspector of Wires.
No.of Receptable Outlets: No.of Switches: Generator KW Rating: Type:
No.Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA:
Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW:
No.Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of Devices:
Swimming Pool:In-Grnd.❑ Above-Grnd.0 Hot-Tub❑ No.of Self-Contained Detection/Alerting Devices:
_No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices:
No.Air Conditioners: Total Tons: Telecom System❑ No.of Outlets:
No.Energy Storage Systems: KWH Storage Rating: Security System ❑ No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment:
No.of Modules: Roof-Mount 0 Ground-Mount❑ Level 1 ❑ Level 2❑ Level 3❑ Rating:
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy)
Date Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: M,.(I-L 1Z- cpc..ries 0,e"Z '`c►v`v-1 i uc. A-1 0 or C-1 0 LIC.No.:
Master/Systems Licensee: (\t CAL- �OM4 LIC.No.: Z s-u gciA
Journeyman Licensee: it 'l LIC.No.: 117.911.0 g
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address:
Email: Telephone No.:
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
•
• Licensee: Print Name: CAP-h-i-e1.. Nfl Cell.No.: 11�"��7 L-r°V1>Lj
INSURANC C GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee
provides proo liability 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:
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 0 Owner's agent 0
Owner/Agent: Tel.No.:
Signature:
Email.: