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HomeMy WebLinkAboutBLDE-23-005253 Commonwealth of Official Use Only d, , Permit No. BLDE-23-005253 Q Massachusetts 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:3/24/2023 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) 52 PRINCE RD 1L1 ' 1 Owner or Tenant PAUL CRUZ Telephone No. Owner's Address 52 PRINCE 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: Miscellaneous work per attached in garage. 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 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. Tons Tota No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Space/Area HeatingLocal 0 Municipal No.of Dishwashers P KWConnection ❑ Other: HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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. FIRM NAME: LIC.NO.: 56863 Licensee: Ruy Coelho Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address: 15 Nancy Lane, Hyannis MA 02601 *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. I Owner/Agent 'PERMIT FEE: $75.00 Signature Telephone No. ''ZD- Q '( leis le K(R ts(4 z-1 tc (ge-0„11, tqe-rui_ %octeey- A (&15064.c. gligadeir -Atti (ti LATI(m) Cr- t,.4.0 1:4.t_. A toi r- - RECEIVED MAR 23 2023 nweaf .ci aeaarkaestfd Official Use Only ■ , .4i •"fiiNG DEPARTME c7 {� Permit No. s�artmsnf o�,}its Jsrvicse `-. I I Y ---- Occupancy and Fee Checked '' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) l' 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: 03 -2 _z 3 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. N Location(Street&Number) 52 fir-/'7 c e Owner or Tenant 4 CR()' Telephone No.7jz - 0-55 37 .C� , ^ i Owner's Address 2 Pry C ' At- Is this permit in conjunction with a 4uilding permit? Yes, ] No ❑ (Check Appropriate Box) Purpose of Building t?Ee'./ el Pr C.e a L. Utility Authorization No. zExisting Service Aar' Amps ll0 /L'Volts Overhead 4 Undgrd C No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity .. Location and Nature of Proposed Electrical Work: Pd1/.6i2 /J61,-7-0, 3 @ e ,rz tc' C4a tctt-- k©ovn W h, r hog Th �� Eta<C.-et // 6 �l 1 Nr� Completion of the following table may be waived by the Inspector of Wires. V ° L No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total CI Transformers KVA 'Z NNo.of Luminaire Outlets No.of Hot Tubs Generators KVA t::\ Above In- No.of Emergency Lighting 47 No.of Luminaires Swimming Pool_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 a Initiating Devices i:,# No.of Ranges No.of Air Cond. Tonsl No.of Alerting Devices No.of Waste Dis osers Heat Pump Number Tons KW No.of Self-Zontained P Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Local 0 Municipal 0 Otl1er, PConnection No.of DryersHeating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: No.H y g No.of Devices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: 2 C9Z 2e e.e. (When required by municipal policy.) Work to Start: C. r —2 2-23 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 0 BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: / � Licensee: IR.a C�� Signature LIC.NO.: SE R6 3 -6 yN (If applicable,enter exfmpt"in the license number line.) Bus.Tel No. 4-E3 4;300 Z5-"'Z Address: / S /vtlIt CY c 4 ct-`ta' .- A- //el-/i` 5 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)0 owner 0 owner's agent. Owner/Agent Telephone No. I PERMIT FEE:$ Signature