HomeMy WebLinkAboutBLDE-23-005385 P
Commonwealth of Official Use Only
E Massachusetts Permit No. BLDE-23-005385
V
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:3/30/2023
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) 57 KENCOMSETT CIR
Owner or Tenant ARAUJO RICHARD M Telephone No.
Owner's Address ARAUJO CLAUDINE M, 57 KENCOMSETT CIR,YARMOUTH PORT, MA 02675
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 ❑ Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Miscellaneous work per attached.
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 8 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 6 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. 1 Total 3 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 ❑ Municipal 0 Other:
Connection _
No.of Dryers 1 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, at information on this application is true and complete.
FIRM NAME: Michael A Beaulieu
C
Licensee: Michael A Beaulieu Signature LIC.NO.: 17479
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: PO BOX 4084,WESTFORD MA 018860034 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
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RECEIVED !
Commonwealth of Massachusetts Official Use Only
1K_ = Permit No c--23 e
� ' Department of Fire Services Occupancy and Fee Checked:
` 11 ' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/20231
v`''•- <.`^' APPLICATION 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: 3 f /ao�3
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): 7 / MS1 c,/" C,,,,r I e., Unit No.:
Owner or Tenant: IQt c k,4 RtQQr1.j O Email:,3- t et f Q ,o J. �,,.ti
Owner's Address: Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No 0 Permit No.:
Purpose of Building: Q /f,. Utility Authorization No.:
Existing Service: j(Jp Amps,4)0 /a 1/0 Volts Overhead 0 Underground ID- No.of Meters:
New Service: Amps / Volts Overhead❑ Underground 0 No.of Meters:
Description of Proposed Electrical Installation: I etc^ 5 . _n� . ! / MLcJ1yr— ^r`
i Fr- Oc �Ctr���t eTLa.� J_Le saS` r
Completion of the following table may be waived by the Inspector of Wires.
No.of Receptable Outlets: (o No.of Switches: Generator KW Rating: Type:
No.Luminaires: No.of Recessed Luminaires: g- 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-Grnd.❑ Above-Grnd.0 Hot-Tub 0 No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System
No.Air Conditioners: 3 Telecom Tons: y 0 No.of Devices:
System 0 No.of Outlets:
No.Energy Storage Systems: KWH Storage Rating: SecuritySystem y stem
0 No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply
No.of Modules: Roof-Mount 0 Ground-MountpP a Equipment:
0 Level 1❑ Level2 0 Level 3 0 Rating:
OTHER:
./.0 tom. arils_4L,__ ._.Gil L- l' •
Attach additional detail tf desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: .36200.op
Date Work to Start: (When required by municipal policy)
',3 aaju Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: %! ih„,SG —ka-
r l P'1 A-1 0 or C-1 0 LIC.No.:
Master/Systems Licensee: /14 tc,Lt.". l3Ct c It c c
LIC.No.: ,Zyr744
Journeyman Licensee: f t.F1 l eirt 1 i
era Security System Business requires a Division of Occupational Licensure"S"LIC. LIC'No.: ��S�Z�,L•:
Address: "-"` S-LIC.No.:
p llk1...s T 4 03t zeo'
Email:----L1=A t1SG- � -t' C.Urp
Telephone I certify,under the yarns and penalties operjury,that the information on this application is trueand • / / �`
•
f
Licensee.
INSLIRAIVCE COVE Print Name: Sirs 1 (�ei� 1
E. Unless waived by the owner no permit for the performance of electrical work may issueunless the licensee/ L
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 E. BOND g
OWNER'S INSURANCE ❑ OTHER❑ Specify:
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
0 Owner's agent
Owner/Agent:
El Tel.No.:
Email.: