HomeMy WebLinkAboutBLDE-23-002476 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-23-002476
sa' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
jRev.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:11/6/2022
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) 2 MERGANSER LN
Owner or Tenant ANDREW CONDON Telephone No.
Owner's Address 2 MERGANSER LN,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 ❑ No.of Meters
New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install generator.
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators 1 KVA 14
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. Totalo No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other:
Connection
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 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: 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:$75.00
I116
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•
NOV 0 4 2022 /��(` �j 1
-�. NG DEPARTME nwea�h°�rr/��huaa�fe Official Use Only
. r_:.,, 2 Z 7 L
r'+`;#t:` ,/ -- — cc77 Permit No. 6
m,„., Acpartment o`.}ire Services
'_ I I Occupancy and Fee Checked
' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
J _
F 1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
1 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: I "7-7---
City or Town of: vA
Ely this application the undersigned notice intention to perform the electrical wTo the Inspector ��des Wires:
below.
Location(Street&Number) - Ivi+;.t.-t-;•.N-x I w, wcv..4.1 u.rlA
' Owner or Tenant )�j, •e'_r .,7:..)K
Telephone No. SLL -�GIFI—'�g7j�
V O ANl
• Owner's Address
• Is this permit In conjunction with a building permit? Yes ❑ No
❑ (Check Appropriate Box)
J Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters
•
v' 19ew Service Amps / Volts Overhead Undgrd
n1 ❑ g ❑ No.of Meters
>5 Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
/1 YL it �(a.N�i�Ti v w l iE h1.��i'i (L—
'We
Completion of the followingtable mugs be waived by the Inspector of Wires.
�' No.of Recessed Luminaires No.of Ceil.-San . No.oU Total
o./ p (Paddle)Fans Transformers KVA
No.of Luminalre 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 f No.of Zones
e.
No.of Switches No.of Gas Burners .of Ifetectlon and
II! Na of Ran es Initiating Devices
S No.of Air Cond. Total
Tons No.of Alerting Devices
No.of Waste DisposersHeat Pump Number Tous KW No.of Self-Cootalned
Totals:I_ `" "" ' ""� - Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal
No.of Dryers Connection Other
ty Heating Appliances K�,i, Security Systems:*
o.o Hwtien KW O.0 O.o No.of Devices orEquivalent
Signs Ballasts Data fDg:
No.Hydromassage Bathtubs No.of Devices or E uivalent
No.of Motors Total HP a ecommun ca ons r g
p {ER; No.of Devices or E uivalent
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work:
Work to Start: (When required by municipal policy.)
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
I certify,under the pains and penalties o e u that the information on this application is true and complete.
FIRM NAME: N1,rr+z< f.- N ryr
Licensee: LIC.NO.: k 7I-11?G¢j
afapplicable,enter"exempt"in the license number line.) Signature ----_
LIC.NO.: Zti�
Address: Bus.Tel.No.0-2±3. (,-
*Per M.G.L. 61,security work requires Departrnent of Public Safe 5"License: Mt.TeL No.:
L
Lic.No.OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n
required by law. By my signature below,I hereby waive this requirement. I am the(check one • owner • owneormally
r's a•ent.
Owner/Agent
Signature
Telephone No. PERMIT FEE:$ ,