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Home My WebLink AboutBLDE-23-000777 f �/'' Official Use Only or ,i ►' � Commonwealth of u 10 Massachusetts Permit No. BLDE-23-000777 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:8/16/2022 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) 111 STARBUCK LN Owner or Tenant GAIL BURNS Telephone No. Owner's Address 111 STARBUCK LN,YARMOUTH PORT,MA 02675 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement split A/C. 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 TotalTransformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ElNo.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. 1 TTotal No.of Alerting Devices n No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained Totals: Detection/Alertine Devices Space/Area HeatingKW Local 0 Municipal 0 Other: No.of Dishwashers P Connection HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 LIC.NO. 21075 Licensee: Wellington R Soares Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address: 110 BREEDS HILL RD,UNIT 5,HYANNIS MA 026011864 *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 'PERMIT FEE: $50.00 I Signature Telephone No. vlt,z k101► t / Commonwealth o/VaMachuseits Official Use Onnly ' c'� 77 Permit No. Z� "'� r % �.repartment o/ ire�erviced `= Occupancy and Fee Checked ` •`' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) 7\''7LICATIO FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 PRINT IN INK OR TYPE ALL INFORMATION) Date: Vg. )0.2 Z- 2Ay or Town of: .Y4 11-0"10 in if To the Inspector of Wires: By this a $cation the undersigned gives notice of his or her intention to perform the electrical work described below. Le eOf&NurLbe_ lri s-r . I 'Clc I. ,\i& , yea i1 von 1 7Si Zs+ rI3e C.,, e3 ,.. l'enant 44 IL ?jv a IN1 S Telephone No.l SL 4) a 4 42600 C, s adress , 6 1 A A,t1 /3, S to Is t _ei- .it in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Pr ,.. 3oildfog Utility Authorization No. ice Amps / Volts Overhead ❑ Undgrd❑ No.of Meters Amps / Volts Overhead❑ Undgrd El No.of Meters tj i.. _ y 99 r.-t. ....... y ?Ae rs li.itid A_:.pacify i., w_ w _,re of Proposed Electrical Work: 1 k i'.-- tw L 7 L tie i ii i` Pak M E td 1 Completion of the following table may be waived by the Inspector of Wires. -Nor\ . _E sed Luminaires No.of Ceil.-Susp. Trano(Paddle)Fans f T Trsformers KVA _ ' s : .; tlet. No. of Hot Tubs Generators KVA `� ur es SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting grnd. grad. Battery Units N . _<.; ptIFIRE Outlets No,of Oil Burners !FIRE ALARMS No.of Zones G� � es _ No.of Gas Burners No.of Detection and _ Initiating Devices IN c , 1g,es No.of Air Cond. Total No.of Alerting Devices Tons I� ��a. �' .zL�e Disposers Heat Pump Number Tons KW No. of Self-Contained (i p Totals: ,Detection/Alerting Devices N o L ' ro usher s Space/Area Heating KW Local❑ Municipal El Connection 1Nk ,4 Heating Appliances KW Security Systems:* No.of Devices or Equivalent 1y, KW No.of No.of Data Wiring: 'rs Signs Ballasts No.of Devices or Equivalent �� ruwssa, Bathtubs � o of Motors Total HP No. Wiring gNo.of Devices or Equivalent Attach additional detail if desired, or as required by the Inspector of Wires. Esu_ i_ec -e of Electrical Work: (When required by municipal policy.) work sto ,,..art: Inspections to be requested in accordance with MEC Rule 10,and upon completion. t ] L M�CG IERAG E: Unless waived by the owner,no permit for the performance of electrical work may issue unless '}. provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The Lai, .certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. PNSU'RANCE f BOND E OTHER ❑ (Specify:) x eo the pains and penalties of perjury, that the information on this application is true and complete. . _ . : b ngi R Soares, Inc, / ) LIC.NO.: 21075A _ . , eU'ingtc.~n R Soares Signature OC/ <. LIC.NO.: 11376B ' 'il.:'Jl Aec Sri-iilli fi°,'unii"5°flryan'Ai is, MA Bus.Tel.No.: 508 778 5936 Alt.Tel.No.: 774 836 5877 7- _,security work requires Department of Public Safety"S"License: Lic.No. °SI.R�NCf WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally re law. By my signature below,I hereby waive this requirement. 1 am the(check one)❑owner 0 owner's agent. :, . Telephone No. PER)WIT FEE: $ st -- P •