HomeMy WebLinkAboutBLDE-22-004146 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-22-004146
B81A D 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:1/25/2022
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) 52 PRINCE RD
Owner or Tenant Paul Cruz Telephone No.
Owner's Address 52 PRINCE RD,WEST YARMOUTH, MA 02673
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check ‘. V
Purpose of Building Utility Authorization No , ,411
' ,Nik�t
Existing Service 100 Amps Volts Overhead 0 Undgrd 0 `i
New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Ur
Number of Feeders and Ampacity n 1L1(�
Location and Nature of Proposed Electrical Work: Total remodel&upgrade service. L l
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/Alerting 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 Ballasts Data Wiring:
Heaters Signs 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 ❑ 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:$180.00
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1;`..4 M 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 INFORM4TION) Date: C/i. 2/. °Go,ei,
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) 52 ?R4 ij ce (Z4.),4-p 1 W g's 7 '-JA1.44 a V TA
Owner or Tenant _ ?MI- Cat) Telephone No. 771j 9 30 S`33 9
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: 1QOu 6,N 6 F I Niat to '4011 S /2 *t 0 D L_ UP Lima ic ao ii 10 0 A
a= 2-twA u P mk., 644v .,D 5-6 FU/iC 1 Oi4 _TC
kil Completion of the followin table my be waived by the Invector of Wires.
,; No.of Total
U. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans
} Transformers KVA
�t No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
and. grnd. Battery Units
-t No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS JNo.of Zones
No.of Switches No.of Gas Burners No.of Detection and
- Initiating Devices
1 w` 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/Alertin Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal ElConnection
No.of Dryers Heating Appliances KWSecNo o yyf Devices s 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 Winn
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 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: , Lilt, /2__ y k .J T-1-.4_ LIC.NO.: Z 4 0 j;S A
Licensee: Signature LIC.NO.: // 376 5
(If applicable.enter"exempt"in the license number line.) Bus.Tel.No.•
Address: Alt.TeL No.:
*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:$ f 2 a —
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