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HomeMy WebLinkAboutBLDE-22-005041 Commonwealth of Official Use Only Permit No. BLDE-22-005041 ��'� 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/N/NK OR TYPE ALL INFORMATION) Date:3/11/2022 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) 18 SKIPPER LN Owner or Tenant Marcos Ferreira Telephone No. Owner's Address 18 SKIPPER LN, YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Apprte Box) Purpose of Building Utility Authorization No. 7970& Existing Service Amps Volts Overhead 0 Undgrd 0 o.of —41 New Service Amps Volts Overhead 0 Undgrd 0 ems• O Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New wiring. ` © ie,_ , Pam. Completion of the following table may be w i e b hi Itaspeclpr of Wires. No.of Recessed Luminaires 60 No.of Ceil.-Susp.(Paddle)Fans No.of / 1 Transformers �7 � At Generators // � No.of Luminaire Outlets No.of Hot Tubs /7..3 No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 80 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 30 No.of Gas Burners 1 No.of Detection and Initiating Devices No.of Ranges 1 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 1 Space/Area Heating KW Local 0 Municipal ❑ 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,that the information on this application is true and complete. FIRM NAME: Licensee: Marcos Ferreira Signature LIC.NO.: 56463 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 156 Breman Street, Boston MA 02128 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) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 44 __ ( R^CEI _ED IZ L �r -/ak I MAR d7 iI 22� ! // • .• BU IL DINGPA i.."`z,"'!� COn+r'aa�tli o/ aaeacaruoiie olrcid Ute Only Br.. cry:.1,•w i c�77 • �_�}� M _ =:a;„ 2partmaato`.};,yS.rvicen Permit No. — J I1_J BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 (lave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed is accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 YPLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: , -d — By this application the undersignedYARMOUTH To the Inspector of Wires; gives notice of his or her intention to perform the electrical work described below. I Location(Street&Number)�8 s �r/ey Z 1-1 Owner or Tenant }7) vi�� �ti Pi r TeteohoneN Owner's Address /cS'2�a1 Is this permit In conjunction with a building permit? Yes ❑ No e Purpose of Building Utility (Check Appropriate Box) Utility Authorization No.,2 )3 Q y 1 Existing Service d 7 Amps -� / Volts Overhead la O t,l Undgrd❑ No.of Meter, _ New Service — Amps Mate,/afro'Volta Overhead C. Number of Feeders and Ampadty Uodgrd No.of MetersLocation and Nature of Proposed Electrical Work: 1 : fes.. Cr}z_. --r"..,LY s L`' 4�ho✓ yo-T V1 r "� SLY �C r U�vi Cam tartan o the ollowm !e m be waived b the Ins actor o Wires, No.of Recessed Luminaires No.of Ce11:Sas " p•(Paddle)Fans o•o ota � No.of Lumlaalre Outlets No. Transformers KVA of Hot Tubs Generators KVA •t No.of Luminaires .ZO Swimmlug pool rnd. o.ve o_ BetteUnitsmerg cy g m nd. as Units g No.of Receptacle Outlets ,e7 No.of OU Burners FIRE ALARMS No of Zones No.of Switches 3e7 No.of Gas Burners o.o election an No.of Ranges / Devices I'. 1 No.of Air Cond. ors InitiaHn Tons No,of Alerting Devices No.of Waste Disposers 'eat'amp 'um er . "" Totals: ..'—'"_' -�._.........._.. o.o e onto see No,of Dishwasher DeteNion/Alertfn Devices Space/Area Heating KW KE Y Lc l Cr un c ao o OtherDers / HeatingApplance u yystemsElo er No.of o'o oo DatNoWlrinDgevices or uivaentHeaters SI ns Ballasts Na of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP c ecommuo ca ons r m : No.of Devices or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: •rfl(2 (When required by municipal policy) Work to Start:_02 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 LEI BOND 0 OTHER❑ (Specify:) I sertlfy,under the pains and penalties ofperytrry,that the information on this application is true and complet FIRM NAME: os .re. O// /v C/�,.., Licensee: 'Sfj NL.5 A LIC.NO.: (If applicable.aver Signature WC.NO.: Address: . ��t e tisane insulter line� •Per M.O I.a 147 a 57-ir security rlc�rle� �d' D�j„7 sz Bat.Tel.No. (�,2 cf OWNER'S INSURANCE WAIVER:it quires Department of Public S. Alt.Tel.No., I am aware that the Licensee does not Safety the liability insurance coverage normallyrage — required by law. By my signature below,I hereby waive this requirement. I am the(check one ■owner ■owner's a:eat. Owner/Agent Signature_ Telephone No.