HomeMy WebLinkAboutBLDE-22-004735 i or r
Commonwealth of Official Use Only
f Massachusetts Permit No. BLDE-22-004735
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,t Date:2/25/2022
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) 11 CADET LN
Owner or Tenant Carlos Ferreira Telephone No.
Owner's Address 11 CADET LN,WEST YARMOUTH, MA 02673
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check ° ppriate Box)
Purpose of Building Utility Authorization No. C f .'
Existing Service Amps Volts Overhead 0 Undgrd 0 No, if,
New Service Amps *�
Amps Volts Overhead 0 Undgrdetr3 , ,,
Number of Feeders and Ampacity "�: � 1)
Location and Nature of Proposed Electrical Work: Remove&rewire dwelling �1'.__ e 4. a
Completion of the following le ay be( i y„ ector of Wires.
No.of Recessed Luminaires No.of Ceil:Sus . Paddle Fans No.of Total
p( ) Transfor ersyflb, VA
No.of Luminaire Outlets No.of Hot Tubs Generators ! A
Z
No.of Luminaires Swimming Pool rnd e ❑ Irnd. ❑ No.of Emergency LU;h g
g h 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 Device
No.of Ranges No.of Air Cond. Totalo No.of Alerting Devices
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 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 ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perfuty,that the information on this application is true and complete.
FIRM NAME: Marcelo R Soares
Licensee: Marcelo R Soares Signature LIC.NO.: 13036
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:53 FALMOUTH SANDWICH RD, MASHPEE MA 026494307 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) ❑ owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $510.00
(21Z5UCe,4 )1 17(7/7
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., ��, ?cook No. �i22 -- 3 r?
�l ,� 1
FE�! ? '� 1 Day and F=C6eoked
= 0' -■ DF FIRE PREVENTTOON REGULATIDNIS IRrv.i/o7] Cleave blank)
BUILDING D "P :T -.T
BY ---- A ION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be rmincued is l l Code a ..4 5z7 ChM 12..0D
(P r.>«.erR;PRINT.12i11iS OR Tin ALL INFORMATION) Uafzw 7- I ('74i
City or Town af: To the hnrpectbr of Wires:
By application tie undersigned gives aati=ofixis ix her inter to perform.tie elschirdl work d mewl:ed below.
Location(Street&Nnmber) I\ C t T)-6;T i,h) WV-0 I` `uv
rik
Owner or Teozant CH-L R1 l 12Pt Telephone No.t ''Y -1' Pt
'Owner's Aridness •
Is fail permit m cmnjancdirm with.a building perm? Yes 0 No 0 (Cluedrbpproptiatr Bair)
Purism of_uBdi org • tYt1i y dudtbora on Na.
Existing Service Amps / Yobs Overhead❑ tintigrd❑ Na.of hiders
New Servirr Amps / Yobs Ovetilead 0 tIntigrd.❑ Na.of Meters
Number of Feeders stud Amg' y
La cs:Soo and Natm r of Proposed Electrical Work 1) V t;C tC,ck 1. a IvyP4-- `V Til 0 i AA
. N ';1 t tt\ ice. b -- \ C c rit--- .vL-v
C ,off following-table may be waived by the.h r csfiWi-o.
No.of Total
Na of teem:wed T,meiRaires No.of Ce..-Sasp.(Paddle)Fans Transformers KPA
No.of I mb:mire Odds Na.of Sot Tubs G� KvA_
Na of T umin i,es bWmImmg Poolrzw ° ❑ cmd•• ❑ N , ritg y Ltglatmg
t3mta
No.of Receptacle Dat1eta Na.of OIL Sinners :M E ALL R kin.of Znnes
.Na.of Detection and.
No.of Switches 'No.of Gas R>rsoers Ttriti v Devices
• • Na of Rages Na.of Air Cond. Tam No.of Ale rt ng Derirss
Heat rump Nmnber-Toss KW Na of Sod-Ca rood
Na of Waste Disposers Totals: D ion/Alerr. Devices
Na of Dishwashers SpnxJArea Reining KW Loral❑ ignniimViL ❑ oar
Na of Dryers Heating Appliances KW 5�o.of Devices or Erfaiv-ale t
Na.of Water , No.of Na.of DataWriny
Sea SignsBallast Na of Devices or Equivalent
Teleeoninri+sir-afirma "klieg:
Na.Eydromassage Ra#kh¢bs No.of Motors Total HI Na.of Devices or Equivalent
OTE ER:
Attach addd Tonal de mi p'desired or as required by the r of Ffres.
F eFrn Valve r,f lms:I deal ytWorla ( k=.required.by a>un.ieipal policy.)
Work to Start InapecOrms to be requested in ar=orclance with 1VC Rule IL,and upon complation.
I N tJRANC E COVERAGE: Unless waived.by the owner,no peerataf'br the sty of electrical work may issue tiles
the licensee provides proof of liahiiJ y ioninneee in- mg` letcd apt coverage or its substantial.equivalent The
-tamicoziguzi eertifias that such covemge is iaforoe., and has eshibii:ed proof of same to the permit issuing cdFice.
r rg"arts: INSURANCE 3 acap ❑ OTC ❑ (sl r•)
I r 5,render fife pansy aridd penafbier•of perjury,tiaat the i:tfarmafioa on this appficoarion is twee and.congele e.
FIRM NA E: jtll C't 1.:.) 1 : S0tr•t-4- i✓'l c(-.,q..w*i Ito NO.: 0)ill 6 C
r;e u Signature _ LIC.NO.: 2?-GCtGCA
(If applicable,ea ze�r"ot"in the£ice zee number Line) C._./ Ens.TeL No:-114—-Y.17 b`L`''' i
Address: 1C ) y) Vire-A UJ Sirt.f4witcAt. MA 5 Att Tel No.:
*Per M.G.L. c. 147,s.57 L,aeemdty work.requires Departamot of Public Safety"T''Lieeasc: Lie.No.
OWNER'S IPTSURANCE WA1VJstt.: I am aware that the Licensee doer not have the liability iasumns cdge normally
required by law. By my signature below,I hereby waive this regt remoat. I_ fat(rhrrir one)0 owner 0 owner's agent
Owner/Agent Telephone Na I P ' h_ .e&E: $ ` ) CA) 1
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