HomeMy WebLinkAboutBLDE-23-002409 Commonwealth of Official Use Only
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EA% Massachusetts Permit No. BLDE-23-002409
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:11/2/2022
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) 80 ROUTE 28
Owner or Tenant ARIEL SUAREZ Telephone No.
Owner's Address
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 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install GFCI receptacles as needed and cover light fixture in cooler.
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 Above ❑ In- ❑ No.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 ❑ 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: $100.00
__ Comnwnuiea[th.of Maedackudeifd //Ofcial Use Only
>_-v;: : , cc�� cc77 Permit No. V -24 C 5
oCJarartment of ire Serviced
" � BOARD OF FIRE PREVENTION REGULATIONS [Rev1/07]Occupancy and Fee Checked
'' (leave blank)
n
, ' . APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
J (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 4 0 , 3 4, 2,Z
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below. M
�j k) Location(Street&Number) o too-7e z w
e , �S7 y.4-e_AiD U 1H
i_ 1 Owner or Tenant A4- RA E `..- s v ASP Z Telephone No.$O' 36 it 612 it It
gOwner's Address
Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box)
V' Purpose of Building Utility Authorization No.
VI
p Volts Overhead❑ Undgrd E No.of Meters
- ExistingService Amps / p
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
i
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: ( 1 o'i'+t 1 s t.npiofec c ill+he, ki4cIi..v1 uvel� , t
ins-tall covey In wall< 1h cooky - ix4vrt
•`r y Completion of the followingtable may be waived by the Inspector of Wires.
No.of jl. otal
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers TKVA
'`-1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA
~\ No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting
grad. ❑ nd. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones
" No.or Switches No.of Gas Burners 'No.of Detection and •
C.
Initiating Devices
1.' 1 No.of Ranges No.of Air Cond. Total No.of AlertingDevices
Tons
No.of Waste Disposers Heat Pump Nu }mber Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Othev
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water No.of No.of
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 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: Vide 1°tt� �-./ t O - --y i//C 7<u c.I A-sJ ilk-.)C LIC.NO.: 2 I V 7.( A
Licensee: VU e -► A .SDPk 'irSignature LIC.NO.: 41 37 to • 3
(If applicable,enter"exempt"in he license?amber line.) �
Bus.Tel.No. e '778 S q%,
Address: /10 /5.70- I-f(CC_ POAI / Alt.Tel.No.: 774 ??3161P77
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)❑owner ❑owner's agent.
Owner/Agent
Signature — Telephone No. PERMIT FEE: $ (12-Dt
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