BLDE-21-001631 . Liner Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-21-001631
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.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:9/29/2020
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below.
Location(Street&Number) 9 SILVER LEAF LN
Owner or Tenant DAMATRY MAZHEIKA Telephone No.
Owner's Address MA
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check A opriate Boxjr/
Purpose of Building Utility Authorization No. ,
Existing Service Amps Volts Overhead 0 Undgrd 0 o. pi,,,i
New Service Amps Volts Overhead 0 Undgrd 0 o osr
la r
Number of Feeders and Ampacity4!'JO 0 ,?, rLocation and Nature of Proposed Electrical Work: Replace damaged SEU &weatherhead.
Completion of the following table may be w.• i. .y r ••ctor of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 'fit 1
Transformers
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- CINo.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
Initiatine 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/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 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 Siens 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 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:$50.00
f' \e6N U. iuk0 Peps 4 Ism Lc' . 1'2370-0
,
14 Commonwsatth e/flasaachusetto Official Use Only
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..7. '•t c� Permit No.X2-1 -- (603({
i 2spart`msnf el cc-��irs.Ssrvicsd
N �' 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
.i (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:
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) Ci S IL kJ&(t- i..-6 1%-P L-A-r & W S7 yM f"rt�t'Ttk
Owner or Tenant .15 1"1 A.-3 (C� Telephone No. Sad"Z 9Y ZSL 3
Owner's Address �J
4Is thispermit in conjunction with a buildingpermit? Yes No
j ❑ ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
0....
{ Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
INew Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
?4 z! Number of Feeders and Ampacity
i Location and Naturetof Proposed Electrical Work: a-P1.40, 6!C(S it 1 Sett vitt eN1nAn1C& i)4-114(,ea
c, cA., , AiiD (A.6*7 ATG' "f`..')
Completion of thefollowingtable may be waived by the/ ector of Wires.
i,1i No.of Recessed Luminaires No.of Ceil.-Sasp.(Paddle)Fans Trf "ot
Y Transformers KVA
�t No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimmin Pool Above In- No.of Emergency Lighting
g grnd. Q wild. Q Battery Units
.. No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
'No.of Detection and
\--- No .of Switches No.of Gas Burners Initiating Devices
(i,t No.of Ranges No.of Air Cond. Total No.of AlertingDevices
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 0 Co nnection
ntic 0 ocher
Co
No.of Dryers Heating Appliances Kit Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Eqquivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wirin • -
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 c.v. :ge is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE L% BOND D OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on(his application is true and complete.
FIRM NAME: 1V LL(N‘1,01.) E--, Sr0A-A5-r 6 cc Cl(4,0404 /N C LIC.NO.: Z 4 07S4
Licensee: W Li.t k(,)-(0e R- SoA-JLth Signature C,(1/7.,y LIC.NO.: 14 376 g
(If applicable,enter'exempt"in the license number line.) Bus.Tel.No.: '.77h -7)Sr 5936
Address: I/O ,3 4 EDr 14-i Gt.- 1L'OD.44.- di S-, .41/,vi.i M4 Alt.Tel.No.: iii 77 4 & 6 Ybr77
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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 Q owner's agent.
Owner/Agent I
Signature Telephone No. 1 PERMIT FEE:$ 67)1