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Home My WebLink AboutBLDE-23-003682 Commonwealth of Official Use Only 1 Massachusetts Permit No. BLDE-23-003682 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:1/6/2023 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) 583A FOREST RD UNIT 1 Owner or Tenant MIKAETY RODRIGUES Telephone No. Owner's Address 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: Make corrections and permit un-permitted &un-inspected work. 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 Gas Burners No.of Detection and No.of Switches Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local ❑ Connection ❑ 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. required bymunicipal policy.) Estimated Value of Electrical Work: (Whenq p p y. 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: Marcelo R Soares LIC.NO.: 13036 Licensee: Marcelo R Soares Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:53 FALMOUTH SANDWICH RD, MASHPEE MA 026494307 *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: $300.00 Signature Telephone No. 1 Common.weatth o/Memaachudalid Offii„.,=°kr, Permit No. (%2 cial Use�j Only" l c ' 1 ' ,df�; s/oarlmsnl oc-�ir�} a �srvu sd 1y , Occupancy and Fee Checked BOARD OF ARE PREVENTION REGULATIONS {Rev. Il07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 �i (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: j( I el,", '7")-j 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. R.y Location(Street&Number) 5i3 A=(.,rL-'S-, lz 0Li;,./Li 1, i Owner or Tenant t t t JY�),; ;_v;)ti,tti,t;X:"< Telephone No. ' M Owner's Address p �� 1 G Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd E No.of Meters NNew Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 2.(-vnvvt ,,•r,,-) i)eq..tert to 1101 71,c ti, C,,,, ) .kil0 t( a s 7 vtl l:. ) l-t ors s u kr Completion of the followin table may be waived by the Ins�ector of Wires. th No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 1No.of Total !Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Wit:` No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grad. grnd. 0 Battery Units �t No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS [No.of Zones .,— No.of Switches No.of Gas Burners 'No.ofbetection and is — , Initiating Devices No.of Ranges No.of Air Cond. Tons) No.of Alerting Devices No.of Waste Disposers Heat Pump I limber 'Irons KW No.of Self-Contained Totals:L Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipalonnection 0 Other C No.of Dryers Heating Appliances KW Security Systems:* No.of No.of Water a KW No.of No.of Data Wi ingvices or Equivalent HeatSigns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications bung: 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: 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 Ell 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: l‘"G-t ti-Lo f-- ` 9Mei k,f,-G Oi!rr.) LIC.NO.: (12.JlI(, 15 Licensee: Signature ff 2 LIC.NO.: 2 /L %49 (If applicable,enter"exempt"in the license number line.) �,� L Address: v Bus.Tel.No. 174 `ii✓!� E [_ *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt Lie T .NNo 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)1❑owner ❑owner's agent. Owner/Agent I Signature Telephone No. l PERMIT FEE:$