BLDE-21-004060 \l/9,
Commonwealth of Official Use Only
1�i lki ,i Massachusetts Permit No. BLDE-21-004060
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 IN INK OR TYPE ALL INFORMATION) Date:1/22/2021
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 below.
Location(Street&Number) 97 TOWN BROOK RD
Owner or Tenant Trevor Barret Telephone No. _
Owner's Address 97 TOWN BROOK RD,WEST YARMOUTH, MA 02673
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check • i i i , date B
Purpose of Building Utility Authorization No. t 24._
Existing Service Amps Volts Overhead 0 Undgrd ❑ `�. : •ters;
New Service Amps Volts Overhead 0 Undgrd 0 ij I of p s
Number of Feeders and Ampacity ,'
Location and Nature of Proposed Electrical Work: Provide power to gate motor. v '`
VVV
Completion of the following table may be waived by the lnspec r 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 0 In- ❑ No.of Emergency Lighti
grnd. grnd. Battery Units Mr
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS .of r,efts'
i
No.of Switches No.of Gas Burners No.of Detectio nd �� °^�
Initiating De ces t'
No.of Ranges No.of Air Cond. Total No.of Alertin Devie �� -..\,
Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contai`ed''< ,,, ';°''.' 1,
Totals: Detection/Alertine • vices,, N.
.
No.of Dishwashers Space/Area Heating KW Local 0 Municipa \. 'b , Other:
Connection•y <o' ,r'
No.of Dryers Heating Appliances KW Security Systems:* ti '`', ,. l
No.of Devices or Equivalent\ _
No.of Water KW No.of No.of Data Wiring: 'ti
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors 1 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 ❑ 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: 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. PERM _ *
F
Commot.tosatth of aassachasslte Official Use Only
1'= '''t Permit No.
C=2t—�
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;;.. 2) c7spartm.nt o/.}ire�srvresa
,r BOARD OF FIRE PREVENTION REGULATIONS Rev ip/07)cy and(leave Fee Checkedblank)
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: O 1, 1 9, it
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) 017 1'0W o Bak. RADA-9 I (n)6-i l Y OU l U
vi Owner or Tenant 1e✓i'ilOR— 13--41 R.c 7 Telephone No. �'2 ,is/ `I 3..4
Owner's Address
1 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box)
purpose of Rnilding-- Utility Antitor1za1il11LNo.No.of Meters
Existing Service Amps / Volts Overhead E Undgrd E No.of Meters
New Service Amps / Volts Overhead❑ Undgrd❑
Number of Feeders and Ampadty
Location and Nature of Proposed Electrical Work: QeoV i i* POW6(Z To GATE. M MOO— i N VA-1-t, ;J BY
, DTNe2S , 0ts1�R6 °/-10 G0F) Vi1 iNSr,,U6 lO al o7►f 11/SI Wl/ OU1S�11e G.4-mb-S44P1N6
v, L1 U 14 f i h1 C) PQo U t ix D 13Y 01ItEA-4 Completion of the following table may be waived by the Inspector of Wires.
Total
Lb No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.ofKVA
Transformers KVA
C'1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires SwimmingAbove In- No.of Emergency Lighting
Pool grad. ❑ grad. ❑ 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
1 1' No.of Ranges No.of Air Cond. Tons No.of AlertingDevices
Tons
No.of Waste Disposers Heat Pump Number Tons_ KW Ito.of Self-Contained
Totals: Detection/Alertin' Devices
No.of Dishwashers Space/Area Heating KW Local❑ CoMunic
nneipal ction 0 Other
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 liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coy rage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: W au u6 void,- co.4-6 6 LE(72t C.t 14-1-) (NC LIC.NO.: 2,1 0')C
Licensee: W ELUN610iJ I- SoA,l;l Signature / / ) w......i LIC.NO.: 1/ 376 13(If applicable,enter"exem t"in the license member line.) C!t/ Bus.Tel.No.: SJ& 77 k S U
Address: //V / D' H't/tc. !lhirt-0 # 1-1'1/ JleviS Yle4
I Alt.Tel.No.: 77 V 234 S8 7 7
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER: tam 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 0 owner's agent.
Owner/Agent I
Signature Telephone No. I PERMIT FEE:$ S-01