HomeMy WebLinkAboutBLDE-23-004862 Commonwealth of Official Use only
t. Massachusetts Permit No. BLDE-23-004882
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:3/6/2023
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) 23 PAULA LN
Owner or Tenant KEVIN BARBATO Telephone No.
Owner's Address
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: Installation of solar PV system(22 Panel 8.4 KW)(NO SUPPORT PAPER WORK
PROVIDED)
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 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 Alerting Devices
Tons
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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 Signs 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 0 (Specify:) 5-6e 95i-462 I
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME:
Licensee: MATTHEW COSTA Signature LIC.NO.: 22688
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 196 REED STREET, NEW BEDFORD MA 02740 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: $150.00
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:.....t17, BOARD OF FIRE PREVENTION REGULATIONS (ROecvc.urn/077
and Fee Checked
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0 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
....)
.. ,- All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
...11
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 5/Z/20.1
0
0 City or Town of: Yarryieviii To the Insp tor of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below,
Location(Street& Number) 4/3 Pe4,1a. Le .- Yoe ,M ., 4147.5
ti Owner or Tenant KcAtie% Sorbo+e# Telephone No.
0- Owner's Address rb ?cscje.• I C.N.- , /YA/MOtPlit i Mier CPX7S
p Is this permit in conjunction with a building permit? Yes Er No 0 (Check Appropriate Box)
Z1 Purpose of Building 301r.‘r *Trtykle,..-H." Utility Authorization No.
..." Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters
01 New Service Amps / Volts Overhead 0 Undgrd E No.of Meters
..)1,
....t Number of Feeders and Ampacity n7)46.11 40 411.4p nolzdio volt. arivihinoikinin Sox.
u
Location and Nature of Proposed Electrical Work:
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 KVA
Above ri In- rn No.of Emergency Lighting
No.of Luminaires Swimming Pool grnd. " grnd. L^J Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
tNo.of Detection and
No.of Switches No.of Gas Burners Initiating Devices
Total
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers Totals: Detection/Alerting Devices
rn Municipal r—i
No.of Dishwashers Space/Area Heating KW Local 1.._j •
, Connection L--I °thew.
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP 1 No.of Devices or Equivalent
OTHER: 2Z S:36.r ?mi.s. la.L1 kw Army .
Attach addittbnal detail([desired,or as required by the Inspector of Wires.
Estimated Value of lectrical Work: ArC,500.°' (When required by municipal policy.)
Work to Start: 3 zs ?or,'• Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE C VE GE: 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 [7.] (Specify:)
I cernfv,under thitains and penalties ofperjstry,that the information on this application is true and complete.
FIRM NAME: MP.00 tle,eiTie, , (X. LIC.NO.:•411-4
Licensee: Mti4fAtt,...1 Corte.. Signature,...2 ......"....--- LIC.NO.: trePil-•8
(1 applicable,enter "exempt"in the license number line.)
Bus.Tel.No.:
Address: 142 eeitiNV‘o.e-N %Mc+ I Nam %CALL itAlk , 0274916 Alt.Tel No,:
*Per M.G.L.c. 147,s.77-61,security work requires Department of Public Safety"S"License: Lie. 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)E]owner 0 owner's agent.
Owner/Agent
Signature Telephone No. 1 PERMIT FEE:$