HomeMy WebLinkAboutBLDE-22-004739 Commonwealth of Official Use Only
� �„� Massachusetts
Permit No. BLDE-22-004739
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:2/25/2022
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) 32 OAK GLEN VILLAGE
Owner or Tenant Bob Garcia Telephone No.
Owner's Address 32 OAK GLEN VILLAGE,YARMOUTH PORT, MA 02675
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ap Is ate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 0 o.o
New Service Amps Volts Overhead 0 Undgrd 0 f rs0
Number of Feeders and Ampacity C
Location and Nature of Proposed Electrical Work: Install generator w/Xfr switch.
Completion of the following table may be h�'!n r of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of otal
Transformers j VA
No.of Luminaire Outlets No.of Hot Tubs Generators 1 / O VA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lightinn
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. 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 0 Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Eauivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Signs No.of Devices or Eauivalent
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,that the information on this application is true and complete.
FIRM NAME: Marcelo R Soares
Licensee: Marcelo R Soares Signature LIC.NO.: 13036
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 53 FALMOUTH SANDWICH RD, MASHPEE MA 026494307 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: $50.00
1
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8u1--Lbi N``-Lr/R1 rviEg n's DF FIRE PREVENTIDN REGULATIDNS iRev.LJo7] },b,,,t)
By ------ ---
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All week.ta be padnnaed m a=rociae=vein the L(cnscacl F.►rrh'ir+l Cade(1V .c ,5Z7 aft LZOD
. (2'r.P:4 R 'PRINT IN Dir O T 7'E ALL D FORMITION) gat= O) )4 ,''Y
City or Town nf: y 1, ( } To the Inspector of trey:
By this appfieeinn tic rn+h 'r eel gives t ogiiice afhis na her i re zrm to pe� the r1-r-tri m1 wort d=smheb 6rlow.
m &Leon(street Number) . r - ow (71.0J
Owner or Tame r ekt.C,SA Telephone Na C7V6-Th G li t b
Owner's Address
Is this permit m ennjundion win a buiading permit? Yes ❑ No ❑ (Chest Appm:prcafr Bar)
Parpane of$mpg • Utility-Airorizaficm Na
Isirefing Rervi= Amps / Vald3 Ovenizrad❑ IIndgrd❑ Na of Mats
New 6erviee Amps ! Valis Overhead❑ Undg1 d❑ Na of Meters
Number of Fersiers andAmgary
Loom=and Nate of Propoaed Ele±iral W aric (j L1J j-0-- vu eq.:
-c-R'p*.6 ra`W Tr,1}
Coraplesem of the frarichrizertatilt may be waived by the.hspe=tur of Wier=
Ni. Total
ofE . . __. n Laminaires Na.of Cell-Rasp.(P e)Fans Na of ra KVA.
Tnsformers gVA
'Na.of T r-nr nairr Daflda Na. of Sat Tubs Generators KVA.
•
;Na of Luminaires s**es NPjmiaiag POoI Above ❑ Jerred Ni.a.at H:a.rr .ry l,.ittmg
greet B • ;nets
,Na.of Reeept eke Duflats Na. of DER-amen me to YIPS ALARMS RMe 'Na of Imam
'Na of Bwitrbrra Na of Gras limnersNa of Dunn and
FNi'Eizfiag DePiees
• Na of Ranges 'Na of Air Cond_ Tuna Na.of Alerting Devices
• Na of Wasfz Disposers H�PIIxap Number Tans KW No. of Serf-Contained
Totals: Defy nn/Alcr olz Devices
Na of Dis]¢washers Space/Area Heating KW :Loral 0 Comaed�'an ❑ Oen=
Na of Dryers Heating Appreanees Kw 'SecuNo.of rity Devices irrEquivalent
Na.of Water Na of Na of Data W"
FEW Signs Ballasts Na.of Devices or Equivalent
Na Eydromassage Bat uhs Ni. of Mntnrs Total HP Tr1No of Deiiees o a�r`i:ag
Na of Devices or F�_rmrca le&
Q'ri:
,intaeh oddifrona7 dethi f dcrirg or m required by the lemperdar cf fair=.
F Cfnnhrd vane rifEkatrizat YiWD$ CWhm reqntred by rearreicigal policy.)
Wade to Rtart fuspeetirms to be regriestod m aeszakar=e with lvf.BC Role 1E1,and uprm eaaxplc{ien_
INSURANCE COVERAGE: Unless waived by the ownec,nn pemtrtfor the pednmvcnrr of electrical work may issue unless
the lirousee provides proof cif liability mer„-an=:,,clndna'completnd Dper coverage.or its sabstirdia1 equivalent The
prvlerslcsrrd rs that such ecvemge is allure;lurcc, and has rrFri-rif,-lift proaf of same to the putt iss�.g ice. -
CEiECE ONE: INSURANCE gJ BDND 0 DTfaR ❑ (5pee y.)
I ay.*,ender file pains'andprnalfier offperjrrry, that hie ix/en-median on tfrir app is true and cornp1c ff
FIBMNAME: M R'0-Ce ,.7 '71 L'S -1;TV C ) LIC.NO-: I � b b
Licensee: Signature LIC.NO:2Z(AcWA-V
(If appl able,err "range"in the License ruonber h{z ) / Rua.Tel.No..:-l1 y--Y.171(3--UC/51/4i
Address: ll) 1AW4'OLYNA1Jt: f MM-1A l-N cd*Ct+.L1% 01„ -? Lit TeL Na_:
gIcr M.GL. c. 147,e.57-61,sccartty work requires Department of Public.&Duty"S''Lirrrrsc: Lin.Na.
• OWNER'S LNSDRANCE WAIVic.& I am aware that the Licensee does not have the liability iasemance coverage.nc c sally
required by law. By my signature below,I hereby waive this requirement I am the(rhr*Y one)0 owner ❑ owner's rU-stt
Own nt PELI=,FEE: $ (A)
5ignatune tnre Telephone Na.
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