HomeMy WebLinkAboutBLDE-21-000711 i t"` f_ L.
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1 tA -7Cs Commonuw.alth o`Miodachuwattd Official Use Only
( k�,.= ',.-.ti 219 Permit No. LT Zi --Oo )"71 I
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' BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] leave blank) 1
•`L APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code( EC) 527 CMR 12.00
N. (PLEASE PRINT IN INK OR TYPE ALL INFORMA77ON) Date: /3 f e 0
v\ City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned fives notice of his or her intention t orm the electrical work describe below.
Location(Street&Number) JCL '/i�, d 7j') Ali. a- /1 y0;61/1,144777
•
�� Owner or Tenant ,e , "► ' SO'L/ J Acii S Telephone1'1✓5{1�t/f/
� �f j j/f� !(i/�j_ No.,
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1 Owner's Address %/I (YIP. / Tf/ J i-b G
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Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check A ► o ate Box);
Purpose of Building Utility Authorization No. ,j O
Existing Service Amps / Volts Overhead❑ Undgrd E No.of Meter\
•
bJ' -� New Service Amps / Volts Overhead❑ Undgrd❑ 0 No.of Meters
�` Number of Feeders and Ampacity r/^ /y
. Location and Nature of Proposed Electrical Work: it :Gf'} i. 1j' >�✓, t i" It F,
a C r eLA----) ce ! 'Uri
Completion of the followingtab/e may be waived by the Inspector of Wires.
NA Total
Lb No.of Recessed Luminaires No.of Ceil.-Sasp.(Paddle)Fans No.of KVA
Transformers KVA
'l No.of Luminaire Outlets No.of Hot Tubs Generators KVA
n
't- No.of Luminaires Swimming Pool Above ❑ Tn- ❑ No.of Emergency ncy L lgTfi ing
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones
No.of Switches No.of Gas Burners No.of Detection Devices
K Initiating Devices
11-' ,` No.of Ranges No.of Air Cond. Tans No.of Alerting Devices
t 1 1 No.of Waste Disposers Heat Pump Number Tons KW No.of e - ontaine
`.� Totals: Detection/Alerting Devices
•4 � No. Alt .of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other
Connection
No.of Dryers Heating Appliances Kit Security Systems:*
.7 (0No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
4 j'�'k 1�('V4 No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
P- `n, � No.of Devices or Equivalent
(.�,, U,*+A
(1 `,"' OTHER:
vcspvels ` Attach additional detail if desired,or as required by the Inspector of Wires.
/ Estimated Value of Electrical Work: (When required by municipal policy.)
�J Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
NSURANCE 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
3 fl1�r undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
vs
iy CHECK ONE: INSURANCE ❑ BOND 0 OTHER 0 (Specify:)
t,(0/144' I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:
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: Lic.No.
OWNER'S INSURANCE AIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signore below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent.
Owner/Agent
Signature V'v'-' V.A.A. ' Telephone No. PERMIT FEE:$ 7 5—
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A," :Cr'zi' l,� TOWN OF YARMOUTH
O BUILDING DEPARTMENT
y 1146 Route 28, South Yarmouth, MA 02664
MAT TA =E; 508-398-2231 ext. 1263 Fax 508-398-0836
.F.y..iL .�
K. Elliott, Inspector of Wires
kelliott(&yarmouth.ma.us
August 14, 2020
Admilson Fagundes
112 Captain Lothrop Road
South Yarmouth, MA 02664
Location: 112 Captain Lothrop Road, South Yarmouth
Permit Number: BLDE-21-000711
Dear Sir;
The above noted location inspection failed to pass for the reason(s) listed.
Article 110-12 Mechanical execution of
work.
Article 300-15 Boxes required
Article 334 Extension of circuit
Please forward the required re-inspection fee of eighty dollars ($80.00) to this office and
advise when the corrections have been made and when access may be gained, to the property,
for the re-inspection.
If you have any questions please do not hesitate to contact me.
Sincerely,
Town of Yarmouth, Building Department
K. Elliott,
Inspector of Wires