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Home My WebLink AboutE-19-2162 04:111 Commonwealth of offieialuseonly MassachusettsPermit No. BLDE-19002162BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked VRev.l/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:10/11/2018 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 electrical work described below. Location(Street&Number) 20 LONGFELLOW DR Owner or Tenant PERRY ARNOLD J JR Telephone No. Owner's Address PERRY KIM L,224 CARROLL ST,NEW BEDFORD,MA 02740 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 0 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: Replacement HVAC,washer/dryer receptacles,replace panel. 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 I 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 I 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/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 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 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: 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) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 kCiA (a/'419e ` Lommonweafh of rr/wsacged*lid Official Use Only i.��_—.t S Why cyc7 Permit No. C Ind 2eparimeni el Tire Services -£=1'I ' BOARD OF FIRE PREVENTION REGULATIONS Rev.1/0 ry and Fee Checked `'°.�•„' (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: ' I'D •Oq .1S City or Town of: Y4£410 0T4 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) ZO LOj)(a FELLOW De. YM-mo viti 917E1 Owner or Tenant TODD Telephone No. 774 85.4. 5897 Owner's Address 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❑ Undgrd 0 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: 'Kt:ptha eon(c(, PANEL.NW/ Naw Cl WIT Fd2. WASDEP-'1. DRYER 1N uoSETI ii,ISTcII► N -In CKs RI Pas MU HVAC REPLA(EOENT RERAte MOTIOW Completion of the following table m be waived by the Inpector of Wires. 5jE11S0(t No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Tosd LLTE.Trr KVAansformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA AboveIn- No.of Emergency Lighting No.of Luminaires Swimming Pool 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/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 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: 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 liabili insurance including"completed operation”coverage or its substantial equivalent. The undersigned certifies that such cov age 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 perjury,that the information on thi$application is true and complete. FIRM NAME: Wellington R Soares,at suell LIC.NO.: 21075A Licensee: Wellington R Soares Signature LIC'l> LIC.NO.: 113766 (If applicable,entgrloe r tdsigfhierimiugnb�./jr�e 5, MA Bus.Tel.No.. 508 778 r03G Address: Y Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"5"License: Lic.No. 774 83o 58,7 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)0 owner 0 owner's agent. Owner/AgentPERMIT FEE: $ 9,c SignatureturaTelephone No. I t.