HomeMy WebLinkAboutBLDE-22-007427 - .,Inmonwealth of Official Use Only
fijOIN Massachusetts Permit No. BLDE-22-007427
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 PRINTININK OR I'YPE ALL INFORMATION) Date:6/27/2022
City or Town of: YARMOUTH To the Inspector of Wires: O
By this application the undersigned gives notice of his or her intention to perform the electrical work descried below.
Location(Street&Number) 11 CADET LN .j l O/ "
Owner or Tenant CAQ,i f)5 _rp., g.p j I,,- Telephone
Owner's Address 11 CADET LN,WEST YARMOUTH, MA 02673 Alikk C)
Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check App " :]
Purpose of Building Utility Authorization No. 'c "^•'
Existing Service Amps Volts Overhead 0 Undgrd 0 No.of = riO .j
New Service Amps Volts Overhead 0 Undgrd 0 No.of Me fr V
Number of Feeders and Ampacity '` Ir
Location and Nature of Proposed Electrical Work: Remodel of entire house. (work started without permits.)
Completion of the following table may be waived by the Inspector of Wir
1No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total
Transformers KVA
Jo.of Luminaire Outlets No.of Hot Tubs Generators KVA
).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
lo.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
i
\of Ranges No.of Air Cond. To
No.of Alerting Devices
--,of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices
of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other:
Connection
i.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
j.of Water KW No.of No.of Ballasts Data Wiring:
i;aters Signs No.of Devices or Equivalent
b.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
rHER:
Attach additional detail if desired,or as required by the fr-vector of Wir
timated Value of Electrical Work: (When required by municipal policy.)
ork 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 iml4ss the licens
proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned,*fins ns that Stiepsi
is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) a
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: $250.00
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Occupancy and Fee Checked 7rs
4n , ' BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] ---
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/ ' APPLICATION-ION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
' (P=.,'.18'T'PRINT IN INK OR TYPE ALL INFORMATION) Date: Ofu "Z,t
! LZ�or Town of: YARMOUTH To the Inspector of fires:
City
I ty this application the undersigned gives s oiihce of his of her intention to
Location(Street&Number) i r C t 17&f perform the electrical work described below.
1 Owner or Tenant `� tv--7—L�
Owner's Address Telephon No. 't'j .--�. 1 C
Is this permit in conjunction with a building Permit? Yes 0 No 0 ( v.
Purpose of Building Pro L Bo OP'
Utility Authorizatin^o, V w
Eaistlug Service Amps / Volts Overhead '"�"'"� •
�'.tw ^ rvlr, - ❑ Undgrd❑ V " ;' , ''
- Amps / Volts Overhead 0 Undgrd❑ rs v�
Number of Feeders and Ampaeity .o rs _
aeatian and Nature of Proposed Electrical n'k: � �'
! Coin tattoo o Nu; ollowin, table m, be waived by the Ins, .
1. bk.of Recessed Luminaires es.
Vim' No.otC;ail.-Soap.(Paddle)Fans °o•o eta
'No.04 I.r�tminaire Outlets Transformers KVA
CCI ... No.of Hot Tubs Generators KVA
Kt" No.of Luminaires 've n- 'o.o Units cy g ng Pool d. ❑
No,of Receptacle Outlets d. ❑ Bette Units g
No.of Oil Burners FIRE ALARMS Na.o:hones
No.of Switches No.of Gas Burners 'o.o. r etec inn$n -
i No.of Ranges Initiating Deatkes
No.o Air Cond. ota __.
Tons No.of Aiertiug Devices
No.of Waste Disposers 'eat nmp ^nm er one ^
Totals: ._...`..._..._ _..........__..._. o.o' elf" rtka Dev
No.of Dishwashers DetectionlAlertia Devices
Space/Aren Heating KW Local 0 is 'ps,
her
No.of Dryers Heating Appliances cu Cstem:titan ❑ f
'o.o "a er KW t3 yystems:
No.of n gvics's or nivalent
Heaters KW 'o.o ^o•o ----- _9__
S :us, Ballasts Data Wiring:
No.Hydromassage Bathtubs No.of D vice.i or E i uivalent
No.of Motors a ecomtToo►`s:<� r n :
Total HP
OTHER: No.off De Dea-vices bi: 'i:bivalent
Estimated Value of Electrical Work; Attach additional detail lfdesired,or as regr:tt.,.I by,I�e Irrrlrect of Wires
Work to Start: (When required by municipal policy)
Work
to Start:
COVE Inspections to be:requested in accordance with MEC Rule 10,and
RAGE: Unless waived by the.owner,no work
iropiyt: su the licensee provides proof of liability insurance including" ompleted operation"coverage or its sir» tM:ti&equivalent. The
permit for the performance of elect,'r^,.t° rosy issue unless
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit is.Mt;t 1 ice.
CHECK ONE INSURANCE [ BONDg
I certify,under the pains and penalties o ❑ OTHER 0 (Specify;)
FIRM NAME: fpedun',that the information on this applkation is true and amplete
FIRM
M �.:< = V e-CI'-t .
ace: LIC NO.: 1 _ 615
.
L(If applicable,enter"exempt"in the license number line.) Signature ^
Address: LIC.NO.: Z7 ,C
"Per M.G.L.c. 147,s.57-61,security work requires Ile Bus.Tel.No,:ma c. VI)LiOWNER'S INSURANCE WAIVER: I am aware that the d(�not have the liabilityAlt.Tel.No.:
----------
OWNER'S' law. Byto e License: Lic.No.
Owner/Agent my signature below,I hereby waive this requirement, I am the(check one insurance coverage normally-"
Signature • owner ■ owner's a:ent.
Telephone No. PERMIT FEE:$
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