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Home My WebLink AboutBLDE-23-005130 fk` i'0• Commonwealth of oft it Official Use Only E v Massachusetts Permit No. BLDE-23-005130 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:3/19/2023 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) 21 SULLIVAN RD Owner or Tenant RONALDO DeSOUZA Telephone No. Owner's Address 21 SULLIVAN RD,WEST YARMOUTH, MA 02673 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: Basement remodel(Per attached) 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 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 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:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. ''(egg—45 35" FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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: $75.00 ..kr7 3/4 e I,23 e: CC.-tAttiz 14-/hilt- LLAt60...e Nick-. G'2 AcLi.e.f M e0 X i- -_.) V-t, ' /61)3 ri- 60 4.1446 441)17 C/1. 6q/VAC 7 4 1/2Z e6 7 `1(V V (.5 dcuc- t-i Gi me6 Cit p424- cv• es_p r Rea-Wed. 75-,66 0a4.4_ - r RECEIVED `� 7 wealth of Massachusetts �f- I2Use Only r, Permit No.: Ce ! r 5a E'=__' #'-= D p rtment ofFire Services =.vrt— Occupancy and Fee Checked: -t t= ` fa01ARD O NFI E PREVENTION REGULATIONS [Rev. 1/2023] -- ''" "' --AP A 1 ION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527 CMR 12.00 City or Town of: YARMOUTH - Date: ; /r7 /23 To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the electrical work described below. Location(Street&Number): 2I 50 I l i vcA vl R.ck Unit No.: Owner or Tenant: IRo't cs t A0 Pe.S v 1/4.,c c.A Email: 'rov1 ti iG\.o' o-ey 06\-i.-«,II• caw. Owner's Address: 2[ 5viiivv,v' l;A yes Li�.V ci l—t MA 0z(.073 Phone No.: 50 --3&O -- S"?LiO Is this permit in conjunction with a building permit?(Check appropriate box)Yes EJ No❑Permit No.: 'Bt-V -2-3— UO3 Z.O Purpose of Building: lot vl v°"vo/(,Ie-,yy,c,J-1/ c\Y;islet<.ek Utility Authorization No.: Existing Service: Amps / Volts Overhead❑ Underground❑ No. of Meters: New Service: Amps / Volts Overhead ❑ Underground g ❑ No.of Meters: Description of Proposed Electrical Installation: L v,5 t 1 I Ot-'4 1 e 15 , s w, LA-,-e S , r e c eS S 1 it k i , i✓l civl; S\Ntci lad I SC' cr,--,4- /f y-e Cc„r� 1 ico- 17 .)omot �' �✓1vv'k v� W.:.lev I�`'�''l' Lo e' vv,I rtt/SY��c Completion of the following table may be waived by the Inspector of Wires. No.of Receptable Outlets: No.of Switches: Generator KW Rating: Type: No.Luminaires: No.of Recessed Luminaires: yp No.Wind Generators: Wind KW Rating: No.Appliances: KW: No. Water Heaters: KW: No.Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW: No.Heat Pumps: Total KW: Total Tons: Fire Alarm System 0 No.of Devices: Swimming Pool:In-Grad.❑ Above-Grnd.❑ Hot-Tub 0 No.of Self-Contained Detection/Alerting Devices: No.Oil Burners: No.Gas Burners: Video System No.Air Conditioners: Total Tons: Telecom El No.of Devices: lecom System❑ No.of Outlets: No.Energy Storage Systems: KWH Storage Rating: SecuritySystem 0 No.of Devices: Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment: No.of Modules: Roof-Mount❑ Ground-Mount OTHER: ❑ Level 1 ElLevel 2 ElLevel 3 ElRating: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Date Work to Start: (When required by municipal policy) Inspections to be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: A-1 ❑or C-1 ❑LIC.No.: Master/Systems Licensee: LIC.No.: Journeyman Licensee: LIC.No.: Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: Address: Email: Telephone No.: I cert ,under the pains and penalties of perjury,that the information on this application is true and complete. Licensee: Print Name: Cell.No.: INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability 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: 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: Signature: Tel.No.: Email.: