HomeMy WebLinkAboutBLDE-22-004067 Commonwealth of Official Use Only
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it.7 Massachusetts Permit No. BLDE-22-004067
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:1/24/2022
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) 38 LAKE RD WEST
Owner or Tenant WEIGEL HOWARD J Telephone No.
Owner's Address WEIGEL ROSEMARY B, 38 LAKE RD WEST,WEST YARMOUTH, MA 02673
Is this permit in conjunction with a building permit? Yes 0 No 0 ( Box)
Purpose of Building Utility Authorization , �
Existing Service 100 Amps Volts Overhead 0 Undgrd ,.. ',
New Service 100 Amps Volts Overhead 0 Undgrd 0 i°..`o.of}"VIc, _ �,
Number of Feeders and Ampacity :'''
Location and Nature of Proposed Electrical Work: Upgrade service,replacement furnace&water heeaa s( ,
Completion of the following table maybe gMIV d`byytlie Ins eq?,..;'i f Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of ( , T :l
Transformers =: A
No.of Luminaire Outlets No.of Hot Tubs Generators ("
No.of Luminaires Swimming Pool gArnd e ❑ I rnd. ❑ No.of Emergency Li ti
g Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners 1 No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alertine 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 1 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 Eauivalent
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:) tt �( ,r
I certify,under the pains and penalties of perjury,that the information on this application is true and complete. �-N-2- � `C
FIRM NAME: JASON CABRAL
Licensee: JASON CABRAL Signature LIC.NO.: 22509
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 196 AMES ST, FALL RIVER MA 02721 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
' C.om.monwealth o/Maaeagueet �iO'fficial Use Only
it ,i11=ai c� Permit No. WZ
-4, .2 epartmenl o/3ire—Cervical
i " BOARD OF FIRE PREVENTION REGULATIONS [Rev.
and Fee Checked
1/07]
—A.. (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:
City or Town of: W e Jr Yarm(1 Z To the Inspector of Wires:
By this application the undersigned gives notice of his or a2tion
to perform the electrical work described below.
Location(Street&Number) Se k a Pd GI
Owner or Tenant C..i-1121.5-el fi-A--1 S. Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? f Yes ❑ No ❑ (Check Appropriate Box)
Purpose of Building K E k7dkm�1„ Si('19 f �iIi j`e Utility Authorization No.7(!y 1 ei 6-7
Existing Service /O 0 Amps 2`fd/ %.Z'/olts Overhead 0 Undgrd❑ No.of Meters /
New Service <OU Amps 2V0/ /lam Volts Overhead �1 Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: tg-,epfa C 5'�1'vic-e �, i`7
P-1°4-1^ t f-cr c A ti (c / -%/'1'15 A -e t✓ �v e"e<
Completion of the following table may be waived by the Inspector of Wires.
No.
rano
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 Switches No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of AlertingDevices
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 El Municipal ❑ Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water Kam, 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 desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 0 (When required by municipal policy.)
Work to Start: I Z ZZ Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE C VEkAGE: 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 petjury,that the information on this application is true and complete.
FIRM NAME: I"I a3S Po Yr (SoI07opj LIC.NO.: 71 if
Licensee: C(A5Qn awl Signature C -i -----�- LIC.NO.: 2250'n
(If applicable,enter " mpt"in the licens um r line. � _� 7 Bus.Tel.No.: COR•02 -021
Address: 116 '//'11 fi a{'J[t n 2 Kl1(6 14/1Z M� O2 ,2 / Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requireVDepartment 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: $50
Signature Telephone No.