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Home My WebLink AboutBLDE-22-004638 � Commonwealth of Official Use Only . or (.9 AMassachusetts Permit No. BLDE-22-004638 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07t 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:2/22/2022 . 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) 28 TELEVISION LN Owner or Tenant ANDERSON ELEANOR M TR Telephone No. Owner's Address ELEANOR M ANDERSON REV TRUST,496 WEYMOUTH DR,WYCKOFF, NJ 07481 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 ❑ 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: Bathroom addition. 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- ❑ 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 Initiating Devices No.of Ranges No.of Air Cond. Tn Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number - Tons KW No.of Self-Contained p Totals: Detection/Alertine Devices Space/Area HeatingKW Local 0 Municipal ❑ Other: No.of Dishwashers p Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent 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 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: $75.00 I ` /v (2/ (g ) g4 Commonwealth o/Maddachudatte Official Use Only '' 1 :tt cc�� cc-'�� {{�� Permit No. t2 -4 3 ": .2)epartmant o/,lira Serviced 't I i``-�` Occupancy and Fee Checked .5, 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 f'' (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: O . . 2 I . 2 2. 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) zg Tat ri L .1A-, LA) “-rk Owner or Tenant r�7V l /�l O j.) Teleph a No. S?)8 776 6O 3o g1 Owner's Address K-74-7/( ' Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Q )f Purpose of Building Utility-Authorization No. I Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters .....tfNumber of Feeders and Ampacity i 1 Location and Nature of Proposed Electrical Work: i -1 H ,pooh Ptb tr7 7/DA; as Vii vo Completion of thefollowingtable may be waived by the Inspector of Wires. W 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 Swimmin Poot Above In- No.of Emergency Lighting g grnd. ❑ grad. ❑ 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 11.? No.of Ranges No.of Air Cond. Tons No.of AlertingDevices Tons No.of Waste Disposers 'Heat Pump 1mber Tons KW 'No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ CoMuninneccipaltion ❑ tither No.of Dryers Heating Appliances KW Security Systems:* No.of Devices 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 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 Stan: 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: 'A)e ‘ c 74-{€.4 d"-) I Al£ LIC.NO.: 2 l 0 7.1 C / to (Mc A Licensee: W e -.SO#''lr.S,ignature P1, LIC.NO.: 41 374 B (If applicable,enter"exe ppt"i he license L- PO number line.) Bus.Tel.No.•.41"d' 778 S 9% Address: /I C �5 a !C 4 A-ab Alt.Tel.No.: 77‹e ' S_l.7 7 *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. 1 am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ 47S j