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Home My WebLink AboutBLDE-23-003707 01111111 Commonwealth of Official Use OnlyMassachusetts Permit No. BLDE-23-003707 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:1/9/2023 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perfornA ele.zical work w.escrib5d}�c'_ow. f -t l ' Location(Street&Number) 476 ROUTE 28 ( /7 —011GG_- ( 'LA Owner or Tenant T Telephone No. Owner's Address 476 ROUTE 28,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Zriate Box)y Purpose of Building Utility Authorization No. ' - / .r • Existing Service Amps Volts Overhead 0 Undgrd 0 i!lo. , e at New Service Amps Volts Overhead 0 Undgrd 0 < l$Ie:'e£�I1V�l-ssi` _ Number of Feeders and Ampacity J / 'r) ~ Location and Nature of Proposed Electrical Work: Receptacles for fire alarm system. `'//// � i sii Completion of the following table may be w` d ' , ector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of ral Transformers <N`` A No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 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. Total 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 Connection ❑ Other: No.of Dryers 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 ❑ 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: Licensee: Italo Azevedo Signature LIC.NO.: 55518 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:41 South Main Street, Milford MA 01757 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $115.00 RECEIVED biI LJANO6 I 2723 J:1„ C n a/ Official Use Oal BUILDING DE-4..7,Eµ NT O°1°1OM1t4°a / mdac ueeile By ._ S' Permit No. �23-3 0 ! , ernrGneni a f a,, a,eieed ^ 111- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.I/o7) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK L...) All work to be performed in accordance with the Massachusetts Electrical Cede EC), 27 CMR 12.00 i (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: i tO �,QJ�3 u City or Town of: YARMOUTH To the Insp ctor of Wires: U By this application the undersigned gives' notice of his or her intention to perform the electrical work described below. i Location(Street&Number) y1(2 rf)()tN SI di Owner or Tenant A I D F N E-ST lq/E 5 T E 12 NJ Telephone No. Owner's Address Is this permit In conjunction with a building permit? Yes No E (Check Appropriate Box) Purpose of Building C OMrv\E R(.t AL Utility Authorization No. Existing Service Amps / Volts Overhead❑ Uodgrd❑ No.of Meters O New Service Amps / Volts Overhead❑ Undgrd El No.of Meters (5 Number of Feeders and Ampadty I.ocadon and Nature of Proposed Electrical Work: T N S i A L L I N Re LE ID fA C E 5 w+r t-I P t RE caoaem 5y5Tern . Completion of the following!able may be waived by the to. c ror of Wires. l1i No.of Recessed Luminaires No.of CeiL-Soap.(Paddle)Fans Tr of 'or ,./ Traesformers KVA ' No.of Luminaire Outlets No.of Hot Tubs Generators KVA d:' No.of Lnmloaires SwimmingPool Above In- No.of Emergency Lighting grnd. ❑ grnd. ❑ Battery Units _ No.of Receptacle Outlets C No.of Oil Burners FIRE ALARMS No.of Zones .1, No.of Switches No.of Gas Burners -N0.of Detection and Initiating Devices IQ No.of Ranges No.of Air Cond. Totalo No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons, KW No.of Self-Contained Totals: _ _....._...__._. Detection/Alerting_Devices No.of Dishwashers S acdArea HeatingKWMunicipal P Local 0 Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:. No.of No.of WaterHeat No.of No.of Data Wiring ces or Equivalent Signs Ballasts 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 f Electrical Work: a'IOQQ.OQ (When required by municipal policy.) Work to Start: t i, d) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO GE: 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 ofperjury,that the info motion on this application is true and complete. FIRM NAME: T LIC.NO.: TALO M4G�I,ugE5 y[Oj Signora �o.I \A) L1C.NO.: 5555 Licensee: (If applicable,enter"exempt"in the license number line.) Address: ,lh {'Egf,t4 �T R 4,- rn'l Oe0 O14S} B .Tel.No.;5o830?'}3j,(� 'Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License:Al.ltLie.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/Agent owner's a eat. Signature Telephone No. PERMIT FEE:$ GX13(?