HomeMy WebLinkAboutBLDE-23-001315 Commonwealth of Official Use Only
E_ Massachusetts Permit No. BLDE-23-001315
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
jRev.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:9/12/2022
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) 179 CENTER ST
Owner or Tenant MICHAEL LATTERA Telephone No.
Owner's Address 179 CENTER ST,YARMOUTH PORT, MA 02675'
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.
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators 1 KVA 20
No.of Luminaires Swimming Pool gr bovend. ❑ gIrnd. ❑ No.of Emergency Lighting
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
Initiatine 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/Alertine 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 0 OTHER ❑ (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
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) 0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$50.00
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ey __ r - to �.`F 2lspartntant o/. u+s Jss.0 ce6 Permit No. JZ?j— 3 l
' `�'' REGULATIONS J BOARD OF FIRE PREVENTION Occupancy and Fee Checked
~ [Rev. 1/07] (leave blank)
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APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ►3- a.�City or Town of: YARMOUTH To the Ins e By this application the undersigned gives notice of his or her intention to perform the electrical workctor ofdeirs ribed below.
Location(Street&Number) t-q-cA Cc-►•1rL.-,L St
Owner or Tenant muikut, LP--
kOwner's Address Telephone No, falt(,'pjaGj-(/(b
0 I Is this permit in conjunction with a building permit? Yes ❑ No
Purpose of Building ❑ (Check Appropriate Box)
fu Utility Authorization No.
Existing Service Amps / Volts Overhead
❑ Undgrd 0 No.of Meters
New Service Amps / Volts Overhead
N Number of Feeders and Ampacity
El Undgrd 0 No.of Meters
�t
Location and Nature of Proposed Electrical Work: O K W
tier
Com letion o the ollowin table m be waived b the In ector o Wires.
t!- No.of Recessed Luminaires
No.of Cell:Sasp.(Paddle)Fans °•° ota
1Z1;t No.of Luminaire Outlets Transformers KVA
No.of Hot Tubs Generators KVA
A No,of Luminaires SwimmingPool °Ve n- o.o mer enc
rnd. nd. BatteryUnits y g ng
`' No.of Receptacle Outlets
No.of OU Burners FIRE ALARMS No.of Zones
'h= No.of Switches No.of Gas Burners
o.o etec on an
`4' No.of Ranges InitiatingDevices
No.of Air ond. ota
Tons No.of Alerting Devices
eat ump um er ons o.o e - onta ne
No.: wa5t1
Detection/Alertin Devo. f Dishwashers Space/Area Heating Kcal Elun c pa
No.of Dryers Heating Appliances KW ecu ty Connection
❑ Other
W Lo
o.o a er o.o No.of Devices or E uivalent
Heaters KW o.° Data Wiring:
Si ns Ballasts No.of Devices or E uivalent
No.Hydromassage Bathtubs No.of Motors
Total HP e ecommun ca ons rmg
OTHER: No.of Devices or E uivalent
Attach additional detail ifdesired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work:
Work to Start: (When required by municipal policy.)
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 LJ BOND 0 OTHER I certify,under the pains and penalties o 0 (Specify:)
FIRM NAME: ift A L� •perjury,that the Information on this application is true and complete.
• S.9lk)2t=S ���P7
Licensee: LIC.NO.:
(If applicable,enter"exempt"in the license number line.) Signature
Address: LIC.NO.: ZZ6ei A
"Per M.G.L.c. 147,s.57-61,security work requires Department of Public SafetyBus.Tel.No.� `L 6 tiG3�
Alt.TeL No.: 1 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage -"
"S"License: Lic.No.
required bylaw. By my signature below,I hereby waive this requirement. I am the(check one
Owner/Agent qnormally
Signature � owner ■ owner's a;ent.
Telephone No. PERMIT FEE:
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