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Home My WebLink AboutBLDE-23-000441 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-000441 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:7/27/2022 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) 17 LAKEWOOD RD Owner or Tenant Damion Johnson Telephone No. Owner's Address 17 LAKEWOOD RD, SOUTH YARMOUTH, MA 02664 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 ❑ Undgrd ❑ 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: Replace distribution 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 Generators KVA No.of Luminaires Swimming Pool Abo ❑ In- ❑ No.of Emergency Lighting grnd.ve 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 Initiatine Devices No.of Ranges No.of Air Cond. Totalo No.of Alerting Devices 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 0 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 Siens 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: 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 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 C 1/i(22 A L am- (07-1,02.tozimimEt9-.„‘fl..0ill � CVO 2 :??) • g4 l.,.omnwnwsaftk o`Maddacl'iudslld fficial Use Only i t t p' "t c ��77 Serviced Permit No. -C ` 1 d _-'�:'; ': `�sparlmsnl o f Jirs Serviced I 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: 0 7. Z ,2 Z • 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) j 7 l 4 tee IN UO D RV19 q is V ltc.4-i ou;14, Owner or Tenant RANI) 0 N L N(N 4 Jo14 A)4-O t'J Telephone No. 774' -2oli 395-d) y, ! Owner's Address -s-,) Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) A Purpose of Building Utility Authorization No. Existing-Service Amps / molts Overhead❑ Unclgrd No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampadty ' 1 Location and Nature of Proposed Electrical Work: f pi_A-c,e 6 (,'I RA CA t� eA-jJ E.(..— ,`. 'it Completion of the following table may be waived by the Ingrector of Wires. Total 1-1 No.of RecessedVA Luminaires No.of Cell.-Susp.(Paddle)Fans No.of KVA ,� Transformers K '. No.of Luminaire Outlets No.of Hot Tubs Generators KVA 't No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting Qrnd. 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 s' Initiating Devices No.of Ranges No.of Air Cond. Total No.of AlertingDevices g Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p° 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 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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: w 6,[AA N G TOh) R- canie-Lr-i rlt.C1,e GcAn) /N C. LIC.NO.: Z/ 0 7 S"4 Licensee: W E Li-i N 4 ZOA) £. c04-/kS Signature C� LIC.NO.: 't 1 3 76-R (If applicable.enter"exempt"in the license number line.) Bus.Tel.No.' 572& 7 7 S `-cl 36 Address: Alt.Tel.No.: 0g -34 4 8723 *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 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:$ S-U —