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HomeMy WebLinkAboutBLDE-23-000062 Official Use On]Commonwealth of y of r►,`_ �:,. '�, ` Massachusetts Permit No. BLDE-23-000062 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:7/6/2022 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) 80 MID-TECH DR UNIT 1 Owner or Tenant U S One Design Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate fo%) 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: Upgrade lightin�q (US ONE DESIGN. Unit 9-1) 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- CINo.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 I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Municipal Local 0 Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Ballasts Data Wiring: 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 S eci I certify,under the pains andpenalties o (Specify:) fperjury,that the information on this application is true and complete. FIRM NAME: EVANDRO SOUSA Licensee: EVANDRO SOUSA Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 22277 Address:202 N QUINSIGAMOND AVE, SHREWSBURY MA 01545 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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: $80.00 - . RECEIVED .;� 3 2O21 �,r _ pEC 1 Co eallk o/ynaeeeu�.tle Official Use Only T -! Permit No. �1i23- Q�� a .4 -D;NG DEPAtijT�N e wf o/.ire�erviced Occupancy and Fee Checked ' tf : • , -D OF FIRE PREVENTION REGULATIONS [Rev. l/07] (leave Z blank) 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 (5 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: l , o a1 �:1 I City or Town of: yI'a a.m pU-r N - r A To the Inspector of Wires: c) By this application the undersigned gives notice of his or her intention to perform the electrical work described below. tit Location(Street&Number) m t b.:'rt C:t, Lb) I 4 q_ Lis Owner or Tenant UI 5 ONE. 'j) 1 N / Telephone Now' 1 , � !j F Owner's Address 11-k566, Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) ,l Purpose of Building Wm E R.C.,i A t_ Utility Authorization No. i° Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters ? New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters c Number of Feeders and Ampadty LL Location said Nature of Proposed Electrical Work. 11) 3 M ,Ci4AN r- r Xi i l,tiS Ii-k+S —o LE ) I IL ht . r^~.^.' { ingtable may be waived by the tnqiecfor of Wires. Lb m No.of Recessed La No.of Total V Transformers ICVA nNo.of Luminaire On r=i � '`} ` 7z�z Generators I�VA No.of Luminaires ❑ No.of Emergency Lighting CU^ �� , Ac.ro>t ;S i4_5.,,,D.jc..,��t 17 --,Battery Units ;' No.of Receptacle On FIRE ALARMS No.of Zones 75 />Ar,vsf7/ /Rt 1)4727/ f3,/ Z No.of Switches "No.of Detection and / Initiating Devices I No.of Ranges �To,-,<-., 4,)i7cLr:sS . i>'F/Si/r No.of Alerting Devices �,�, No.of Self-Contained No.of Waste Disposes `)n?ifc' r ?z.,,,j,,, Detection/Alerting Devices No.of Dishwashers r Local❑ Municipal .1-5 c c=s oils 1 -c 2. ---� Cyonneetion ❑ Other No.of Dryers No.of Devices or Equivalent No.of Water rs ,is f/c'---t-/..ir-` Data Wiring:Heat Equivalent No.of Devices or No.R dro �. Telecommunications Wiring: y massage Bt No.of Devices or Equivalent OTHER: Attach additional detail if desirect or as required by the Inspector of Wires. Estimated Value of Electrical Work: ($ '4-. Al (When required by municipal policy.) Work to Start: 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 Zi BOND 0 OTHER 0 (Specify:) I certify,under thepains and penalties ofperj}u�',that the information on this application is true and complete. FIRM NAME: t. SINS A I c..i it,i C. LIC.NO.: 02: .2-4'1` Licensee: E V ikN DW S., c,JOJS A Signature LIC.NO.: J (If applicable,enter"exe t"in the license numbe rne.) p B us.Tel.No..Gi I tl� `r , Address: 140 n't�i Izir N cz e) i.p A. 1.r�� V CyH— m Alt.TeL No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ 8 , Qd � . CEIVEC RE _ OEC 13 202lee sad O/MaJoacuuasflth O�1Iicial Use Or,,lyn ,, • ,� _'/ TM T n Permit No. 2 �""((�� a lyre„p`NG pE'-PHKs sit of his�ewics3 Occupancy and Fee Checked ' ' ' [Rev. 1/07]~ :" • 'D OF FIRE PREVENTION REGULATIONS (leave blank) Z 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 (PLEASE PRINT IN INK OR TYPE ALL INFOR1tL4TION) Date: 1,2 I tot I City or Town of: "jf.\( MOQ T N - ()')A To the Inspector of Wires: ) By this application the undersigned gives notice of his or her intention to perform the electrical work described below. ili Location(Street&Number) CI(0 m 1'h.•TE O H D k, 1Lh I f e7 _ 1 'Ls Owner or Tenant yi C ONE lb .j ]CyN / Telephone Not'5 3 1 vs( _-3,051 SI 0 Owner's Address r-'i.S li_ © Is this permit in conjunction with a building permit? Yes ❑ No E (Check Appropriate Box) .f) Purpose of Building CO iki E.rC.C_,I A L. Utility Authorization No. (-1J1 Existing Service Amps / Volts Overhead❑ Undgrd C No.of Meters V New Service Amps / Volts Overhead n Undgrd ❑ No.of Meters 01, Number of Feeders and Ampacity 2. Location and Nature of Proposed Electrical Work; \A/0Q K R(Lkd 1vi- il-N') r2 'I DLL- , XIl,:I'\4 S -f-o Len i ,Li-.l'�- Completion of the foUak'ing table may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf Transformers KVA -:, No.of Luminaire Outlets No.of Hot Tubs Generators KVA n ,,^ Above In- No.of Emergency Lighting 't No.of Luminaires Swimming Pool grnd. ❑ grad. ❑ 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 z. Initiating Devices 11' No.of Ranges No.of Air Cond. Total No.o f AlertingDevices 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❑ Municipal Connection ❑ Other 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 No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Vhin No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: : 4-E, 0 (When required by municipal policy.) Work to Start: 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 BOND ❑ OTHER ❑ (Specify:) I certify,under the inss andof penalties perju ,that the information on this application is true and complete. FIRM NAME: l. '�L Pr 61 -C:1 O.lC. LIC.NO.: 22.14' Licensee: C.V iJ D ) ¶, _)00 A Signature E J LIC.NO.: (If applicable, rater"exempt"in the license numbe, ine.) Bus.TeL No.:cl Address: 90 F 10 �R. Ni C.1' tPi n l��-�tj Q,QQ C-,+H- 1 Alt.TeL No.: y *Per M.G.L.c. 147,s. 57-61,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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 8Gl , 6l�