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Home My WebLink AboutBLDE-23-005749 Commonwealth of Official Use Only A.* Massachusetts Permit No. BLDE-23-005749 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:4/14/2023 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) 482 BUCK ISLAND RD Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address RECREATION DEPT, 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463 Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. C 4 1v3 Existing Service Amps Volts Overhead 0 Undgrd 0 No.of,A 's `� New Service Amps Volts Overhead ❑ Undgrd ❑ �£101. , . '•, Number of Feeders and Ampacity ^, Location and Nature of Proposed Electrical Work: Miscellaneous work per attached. :. `..' ,.,.. ale � Completion of the following table may be wuived'y.thejnspeaCc Tres. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Mai.KV ,,, ,� Transformers <_ No.of Luminaire Outlets No.of Hot Tubs Generators KV,A No.of Luminaires 2 Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting f, grnd. grnd. Battery Units , No.of Receptacle Outlets 2 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 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 Siens 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. �y Lib CHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify:) .7 7 !� 3Z4p I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Matthew J Cabucio Licensee: Matthew J Cabucio Signature LIC.NO.: 18116 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:244 KEENE RD,ACUSHNET MA 027431343 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: $0.00 112 C> ri 2-&e K I t'k(23 �'-r, , '�.. 9Jp prG ,`'- ( (SPLti .POD lt0urriaN4 G2ii ) $' /23 klE. 'CAI). , (1-Nral-C 912-1 (2,Z K Official —__ Commonwealth of Massachusetts Permit No.: P—�L3-Sial Use On it_7]-S . ri Department of Fire Services Occupancy and Fee Checked: 311_,.= BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/2023] •-' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in_accordance_with the Massachusetts Electrical Code(MEC),527 CMR 12.00 City or Town of: YARMOUTH • Date: To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the electrical work described below. Location(Street&Number): 4/ g/J!AL 7' /&.lr i� Unit No.: Owner or Tenant: 22&...n 4/-- "(-".02UI.f/t Email:0 ,Soc leta.Vli0i✓s1t rl e f" Owner's Address: SA,&lh y j/ PA- s� r Phone No.: Is this permit in conjunction with a bur ding permit?(Check appropriate box)Yes❑ No 0 Permit No.: Purpose of Building:_Ir.II'e. Si/as, Mal) Utility Authorization No.: Existing Service: Amps / Volts Overhead❑ Underground❑ No.of Meters: New Service: Amps /_Volts Overhead❑ Underground 0 No.of Meters: Description of Proposed Electrical Installation: Ai(v' /r/P It/ SPA,]l`( 1'/4.1)/ Prov/1 7z/97S 54 o t t t VLC& Completion of the following table may be waive the Inspector of Wires. No.of Receptable Outlets: 4, No.of Switches: I Generator KW Rating: Type:. No.Luminaires: Z No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating: No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No:Motors: Total HP: Total KW: No.Heat Pumps: Total KW: Total Tons: Fire Alarm System 0 No.of Devices: Swimming Pool:In-Grad.❑ Above-Grnd.❑ Hot-Tub❑ No.of Self-Contained Detection/Alerting Devices: No.Oil Burners: No.Gas Burners: Video System ❑ No.of Devices: No.Air Conditioners: Total Tons: Telecom System 0 No.of Outlets: No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of Devices: Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment: No.of Modules: Roof-Mount 0 Ground-Mount 0 Level 1❑ Level 2❑ Level 3 0 Rating: OTHER: JJ fG[C.i,t,r —3lR.Ce C�c/susIt elPC.'�-f cook(.. 1J1_C-�Attach additional detail if d ied,or°�r re uired by the Inspe�r of Wires. Estimated Value of Electrical Work:al/ t OOQ i 0 0 (When required by municipal policy) J Date Work to Start:' '/3—Z 3 Inspections toto be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: ](�1COAST/ e.""rr i4 /0aer94df!/*:$A-1jorC-1❑LIC.No.:t 24i Master/Systems Licensee:/YI�/0 �/CA4 UGCO LIC.No.: /4/p// �- Journeyman Licensee: A7,4 r% .eeJ C.46v&'e' LIC.No.: t 3 qgO J Security System Business requires a Division of Occupational Licensure""S"LIC. Alit S-LIC.No.: Address: v7 7 y keel!e AOt. Ae t.koin Nt L[r 7 Z.:4 3 Email: Aizti 7,$p 044(p4s f- &e/',r AJQ Telephone No.:: 7 7 i A2(,- 0 ZEE I certify,under the pain and penalties of perjury,that the information on this application is true and complete. Licensee. Print Name:fi7` ga C A i.e-a-. Cell.No.77 2i26 ' c5?4 INSURAN OVERAGE:Unless waived by the owner, o permit for the performance of electrical work may issue unless the licensee . provides proof of liability 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❑ OTHER❑ Specify: 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's agent❑ Owner/Agent: Tel.No.: Signature: Email.: