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Home My WebLink AboutBLDE-22-003020 Commonwealth of Official Use Only i 5' .- NI (144Permit No. BLDE-22-003020 `; 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 IN INK OR TYPE ALL INFORMATION) Date:11/23/2021 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 I w. 1/J�l r Location(Street&Number) 112 CAPT LOTHROP RD i Owner or Tenant FAGUNDES ADMILSON Te ephone No. Owner's Address FAGUNDES NIVIA, 112 CAPT LOTHROP RD, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Finish work from expired permit(E21-000711) Completion ofthe following table nta 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 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 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/Alertine 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 CQ-0-64,-1 cit. 1 tc( -1 - Ce-aimppArecte �r ►.,a r poop) R. C. ' WED NOV" 2 2 2O o l.ommon.waa[th o/Maaeachudatte Official Use Only ry__ . Permit No.r= — 3 CDZO BUILDING u cry ,=s i cc�� cc'77 � h' .1JsPart»unf o�.}iro�srvicse By ----. c' !I- --- Occupancy and Fee Checked .' '•- BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) 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: 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) i i C t3 P T,-1 i i') L,G T }i R'G 4' — Owner or Tenant Cu.,iv E..K Telephone No. .4 S2 t-C7 i i Owner's Address PmE A hcL Is this permit in conjunction with a building permit? Yes E No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity -4,ici*(4-161C1 Location and Nature of Proposed Electrical Work: \''i Completion of the followin&table may be waived by the Inspector of Wires. "" No.of Total '.1 No.of Recessed Luminaires No.of Ceil:Sasp.(Paddle)Fans Transformers KVA '-'. No.of Luminaire Outlets No.of Hot Tubs Generators KVA C_NNo.of Luminaires SwimmingPool Above In- No.of Emergency Lighting grim!. ❑ grnd. ❑ Battery Units _ '::: No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones -No.of Detection and -1- No.of Switches No.of Gas Burners Initiating Devices 11' No.of Ranges No.of Mr Cond. Totalo No.of Alerting Devices No.of Self-Contained No.of Waste Disposers HeaTotalst Pump Number Tons KW Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ �� Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters 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 of Electrical Work: (When required by municipal policy.) Rork to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. r...._ - -�-. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless IL the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The 8 c'.i 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:) Icertify,under the pains and penalties of perjury,that the Information ott this application is true andcomplete. Li FIRM NAME: LIC.NO.: __.: Licensee: Signature LIC.NO.: v (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: Alt.Tel.No.: 'Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By m_ y signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. Owner/A Signature r...- Telephone No.3-?5),C 3- I t PERMIT FEE: $ 3—Or— imw . ..or . I i i I