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HomeMy WebLinkAboutBLDE-23-002077 /' ,,3_ Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-002077 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 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) City or Town of: YARMOUTH Date: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) 443 STATION AVE Owner or Tenant JORGE HURRALDE Owner's Address Telephone No. Is this permit in conjunction with a building permit? Purpose of Building Ves 0 No 0 (Check Appropriate Box) Existing Service Amps Utility Authorization No. p 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: Kitchen, offices, &store front. 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 KVA Generators KVA No.of Luminaires Swimming Pool g bond.ye ❑ grnd ❑ No.of Emergency Lighting r Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and No.of Ranges Initiating Devices 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 Local 0 Municipal 0 Other: No.of Dryers Connection Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.Hydromassage Bathtubs No.of Devices or Equivalent g No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. (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:) 7 ta(r7 2q, © to ( I certify,under the pains and penalties o.fperjury,that the information on this application is true and complete. FIRM NAME: Licensee: Michael Caramanica Signature LIC.NO.: 22798 (If applicable,enter"exempt"in the license number line.) Address:885 Center Street, Pembroke MA 02359-3621 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 Owner/Agent ) 0 owner 0 owner's agent. Signature Telephone No. I PERMIT FEE:$100.00 I \J, - 2OA/v ei NV4- 41S0 (((.7.2gd4M *4Z3 -DOW i III< C E ! 1 «� �J L I 18 2022 l.ommonwaanh �jaaea `►+ww /// chccdaffe Official S n ,,ay r '�G U�_F'A R 1 N)E;-Department o1,}i,.e Serviced Permit No. ( BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked V [Rev. l/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ,p All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 `� (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) � Date: %(7`I-1 -Z.0�.Z ,'�.) City or Town of: YARMOUTH To the Inspector of Wires: v l By this application the undersigned gives notice of his qr her intention to perform the electrical work described below. Location(Street&Number) i t`�1 O. J Owner or Tenant C;r- e.. 1$ WY' `' Owner's Address Telephone No. ' i -4. . ''�44 2 . i kn v Is this permit in conjunction with a building permit? Yes �' Purpose of Building (,V;y111� ❑ (Check Appropriate Box) Utility Authorization No.__ ` Existing Service yeti Amps /Z / LL Volts Overhead ❑ Undgrd Er- No.of Meters I New Service Amps / Volts Overhead city ❑ Undgrd [] No.of Meters Number of Feeders and Ampa Location and Nature of Proposed Electrical Work: ,i 0` � .,,,/t-n't Ci rk ItL4>1 U s j-ofC Fra4` NA Completion o the ollowin_ table m be waived b the bisector o Wires, Z! No.of Recessed Luminaires / No.of Cell:Sasp.(Paddle)Fans r ° ota r`�1, No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA .` No.of Luminaires • Swimming Pool • .ove n_ rnd. ❑ 'o.o mergUnits cy g mg �t No.of Receptacle Outlets � °d• ❑ Bette Units '� No.of Oil Burners FIRE ALARMS No.of Zones ` No.of Switches No.of Gas Burners 'o.o retec on an t:? No.of Ranges Initiatin. Devices No.of Mr Cond. ota Tons No.of Alerting Devices No.of Waste Disposers eat 'ump 'um er ons • " a o Totals: .o e - onta ne, No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW al •un aim No.of Dryers Heating Appliances KW ecu ❑ty Cyst mstion 0 Oft' " No.of D `o.o aaHeearte rs , `o o 'o o Devices or E uivalent Si ns Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Devices or E E.uivalent No.of Motors Total HP a ecommun ca ons " rung: OTHER: No.of Devices or E 4 uivalent Estimated Value of Electrical Work: 60,003 Attach additional detail if desired,lic ys required by the Inspector of 63lies. Work to Start: '(��(� Z� ' (When required by municipal policy.) 1`._ _ 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE FE BOND ❑ OTHER I certify,under the pains and penalties of er u that the information on this application is true and complete. FIRM NAME: p j ty' Pp p Licensee:���{ (yt/' �, 5ignaiur LIC.NO.: /''! INi C -74(If applicable,ente ex t to the licensg.number line '� LIC.NO.: �Z� i� Address: �+j, !—{f �,j- t p�n tug N] o23 - Bus.Tel.No.- - Vi9-I *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. - Alt.Tel.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 one below,I hereby waive this requirement. I am the(check Owner/Agentowner �• owner's a:ent. Signature Telephone No, PERMIT FEE:$