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Home My WebLink AboutBLDE-22-004639 4k),V14k Commonwealth of Official Use Only : ` 7 Massachusetts Permit No. BLDE-22-004639 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: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) 162 OLD MAIN ST (Oi\I 4!r . G t LAM- Owner or Tenant R Telephone No. Owner's Address , 162 OLD MAIN ST, SOUTH YARMOUTH, MA 02664-4524 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: Check service for re-connection. 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ton 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 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 Signs No.of Devices or Eauivalent 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:$50.00 I N. ..:4—, fie .s m 6 k--18 01.,t ,-rt,v . 1 D s o-LtA(vp.6.,.t 2-6((-2.;-2. t.e_, `)( 4) 'TD(k>0 tom+ �r r>`r„„l Qom,,,' 3 Commonwealth o f aaeachuaalle Official Use(Only// 9 v �r cc�� [Q (� Permit No. e-� "[(p� + .� �Liepartmsnt oT.fira Serviced I z' 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 INFORMATION) Date: 02 17. 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) 1.(o 2 OLD l-lk t N S 1 a S . y mwviou t44 S. Owner or Tenant teem 47-. ,SI L.,i,1,I. Telephone No. irPg ), of 4 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) , Purpose of Building Utility Authorization No. I Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps....T.1. / Volts Overhead❑ Undgrd❑ No.of Meters I Number of Feeders and Ampaclty Location and Nature of Proposed Electrical Work: 5, •x---ti IC. /-4-4r S 6 rJ B f 1✓ KO 2 . 7t-}-A-1) 4 Y6A-f-- . 0 H b OA SAC-11-0(Ck Completion of the following,table may be waived by the Inspector of Wires. tL No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA 'Z No.of Luminaire Outlets No.of Hot Tubs Generators KVA ` Above In- No.of Emergency Lighting No.of Luminaires Swimming PO°l_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 1:1 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 p° Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KWMunicipal Local 0 Connection 0 Other No.of Dryers Heating Appliances KW Security m s:* No. Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring:y g No.of Devices or Equivalent \0 OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. i• 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. 4 INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless CJ 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 o perjury,that the information on this application is true and complete. FIRM NAME: (A)e-ciyv %Z Sate-+ - Ecr t cr,a- i I N(_.. LIC.NO.: Z l 076"fit Licensee: (it)-C4,(.(, -a\ 2 c-arviA--- Signature 7Z, < LIC.NO.: // 27 b g (If applicable,enter"exerq t"in the license number line.) Bus.Tel.No.: 5P$ 771s S'13C Address: Alt.Tel.No.: 774,, t'4 £ 97 c eL. *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 PERMIT FEE:$ 50 i Signature Telephone No. t