BLDE-20-005513 o• . Commonwealth of Official Use Only
(f• , Massachusetts Permit No. BLDE-20-005513
o 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:4/21/2020
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) 32 GORDON LN
Owner or Tenant MELO CASSIO R Telephone No.
Owner's Address 32 GORDON LN,YARMOUTH PORT, MA 02675 '
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check A 4e nate O .
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 0 . O et
.?..,,
___.
New Service Amps Volts Overhead 0 Undgrd 0 No.o 4I i AP'.
Number of Feeders and Ampacity '41 f f
Location and Nature of Proposed Electrical Work: Install conduits underground.Wire gazebo&bar-b-que area.
$b-
Completion of the following table may be waived by the Ins.• 4�'.,. Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Tota
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- 1:1No.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 Number Tons KW No.of Self-Contained
Totals: Detection/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local ❑ 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
Signatures Telephone No. PERMIT FEE: $125.00
/ 1 ct Coy ut`-i- 4(-2,-3(; r
COMPwnw.vaa[Ui o/ addachuas1fe Official Use Only
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�' 't c7 {� Permit No. Fee Checked��J
r, sparttmeni o/•}irs Servicsd
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BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07]Occupancy (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC).527 CMR 12.00
S (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 04.2 0,10
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
' Location(Street&Number) 3 2 &0 g.1do1J LA-N&
Owner or Tenant C-A S Sl D M E L L D Telephone No. X8. 340 78e 7
Q1 Owner's Address
ssIs this permit in conjunction with a building permit? Yes E No ❑ (Check Appropriate Box)
1
Purpose of Building Utility Authorization No.
cib l Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
I New Service Amps / Volts Overhead❑ Undgrd El No.of Meters
Number of Feeders and Ampaclty
fE
Location and Nature of Proposed Electrical Work: ;,t-E,lyp EX:SI M b tiN1DE2be00$ pi CADthiS 0-)TO NMN
, LOCAL tog 11.1 PJAl-1L Y AQ.P . WI RC 6411E6 0/ 0611X1)11. &OWE Ateil
. Completion of the followinktable may be waived by the Inarector of Wires.
4' No.of Total
U No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires SwimmingPool Above o In- ❑ No.of Emergency Lighting
gird. grad. Battery Units
of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
c.
Initiating Devices
1 ' No.of Ranges No.of Air Cond. Tons) No.of Alerting Devices
No.of Waste Disposers Heat Pump Number__Tons_._.KW No.of Self-Contained
Totals: Detection/Alertin Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ me.
Connection o
No.of Dryers Heating Appliances IAF' Security Systems:1
No.of Water No.of No.of No.of Devices or Equivalent
KW 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 covdge is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE p' BOND 0 OTHER 0 (Specify:)
I certify,under the pains and pepalties ofperjury,that the information on this application is true and complete.
FIRM NAME: N Z-(.Q,c.K K- s....,,, w u.,_, / — LIC.NO.: 21 0-1S-4
Licensee: wC'(.f,1�y� �,,p-t lC . Signature LIC.NO.: 11 3 76 3
(If applicable,enter"ex t' to the license number line.) �� Bus.Tel.No.: Sb, 7)&-S�
Address: /"O t��i at,� &#I tt Aoria.,01 , 1ln't 7 S , c HAI-�`/4' Alt.Tel.No.: 77 cf I?3-6 S'877
*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 ❑owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE:$/as,Vq— I