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Home My WebLink AboutBLDE-19-483 „ A. `/ commonwealth of Official Use Only a kE `' Massachusetts Permit No. BLDE-19-000483 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 ININK OR TYPE ALL INFORMATION) Date:7/24/2018 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 elj ctrical work described below. VS: Location(Street&Number) 15 HAZELMOOR RD K Gouty(e)2_ �/0 ` 1 Owner or Tenants Telephone No. Owner's Address .EL, AGAP4BAFIIP4.1,15 HAZELMOOR 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 El 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: Remodel kitchen,wire bath room&workout room. 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 KVA No.of Luminaires Swimming Pool Above ❑ In- o 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 Numher Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection t 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.) 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 Cl BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: WELLINGTON R SOARES Licensee: Wellington R Soares Signature LIC.NO.: 21075 (If applicable,enter"exempt"in the license number line.) Bus.TeL No.: Address: 110 BREEDS HILL RD,UNIT 5,HYANNIS MA 026011864 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 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:$7100 Vo Oct 7/4/it clot_ �e r Ce ► a ctattu ktru ar (4W •F'1IetAct lNottc sew) Vat 1 18 �"tc ,,041- C �z7'- 21st t,u I r WOO 9` Lad-./be n/l rly] tanunonava&of rrladeac lf! O l U ase Only, f c� c7 �s l4 -o463 ,a,e_ of Jiro..ervicee Permit No. _fie ' 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 INFORMAT70P,9 Date: 07, 2 y, ( Sr 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) 5S HvFR-CLM00it- 17.4 I Sot)TA '-/Ai-MOON Owner tor Tenant COI-VILLI Telephone No. Save r/37 3249 Owner's Address Is this permit in conjunction with a building permit? Yes EKNo 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❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: c/reirEA) As-pi vac t._ W t p...‘ / 74ROot•) c wot•.CouT R.00n . ' Completion of the followlittable may be waived by the Inspector of Wires. No.of Recessed LvmInslres No.of Cw7 Snsp.(Paddle)Fans • No.of Total \^ Transformers EVA _ 4.,\i No.of Luminaire Outlets No.of Hot Tubs Generators KVA ,Lt No.of Luminaires Swimming Pool Above 0 In- No. er Unitsency Lighting u o (F {:rrrd. "rrnd. Battery Units eo g No.of Receptacle Outlets No.of Oil Burners "al IT FIRE ALARMS INo.of Zen `49 No.of Switches No.of Detection and v; m a No.of Gas Burners Initiating Devices W I .V w No.of Ranges Na of Air Coml. Tom Tons No.of Alerting Devices V iJ No.of Waste Disposers Heat Pump I Number ITons I KW No.of Self-Contained IJ3 • Totals: Detection/Alerting Devices ,, No.of Dishwashers Space/Area Heating KW' Ian'0 Municipal ea Co No.of Dryers Heating Appliances 1V Security Systems:• No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: 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 rfdesired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start 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 [ BOND 0 OTHER 0 (Specify:) I certify, under the pains and penalties of petjuty,that the information on this application is true and complete. FIRM NAME: Wal-i^I G TON R- S•04-,t,C-7 c (mac c-ret.u4<1 l N C• LIC.NO.: 21 07C 4 Licensee: w E t.t 114 Cr 704) SOMR57 Signature �, 1 LIC.NO.: I l 2 74 L? (If applicable,enter"tremor"in the tleense number line.) UPJ Bus.Tel.No: £V8 - 778 5-934 Address. //O !S-44EE>S Iltci, ref_ , tint b- I 4a'.vt't H.If J *Per M.G.L.c. 147,s.57-61,securiwork re Alt Tel.No.: 775' 234 St 99 ry quires 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 Owered d by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent Signature Telephone No.• I PERMIT FEE: $ C1 — J