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Home My WebLink AboutBLDE-23-005046 Commonwealth of Official Use Only I. Massachusetts Permit No. BLDE-23-005046 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:3/14/2023 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) 134 ROUTE 6A Owner or Tenant CLEVER SIGUENCIA Owner's Address 134 ROUTE 6A, YARMOUTH PORT, MA 02675 Telephone No. 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 gNo.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 owner supplied fixtures. 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 gArnd e ❑ nr ❑ No.of Emergency Lighting Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Municipal Local 0 P 0 Other: No.of Dryers H Connection Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Ballasts Data Wiring: Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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 :) I certify,under the pains and penalties ofperjury,that the information on this application istrue and complete. FIRM NAME: EAV SOLUTIONS Licensee: JEFFREY S DEROUEN Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 22206 Address: 110 Hedges Pond Road, Plymouth MA Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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 Owner/Agent ) 0 owner El owner's agent. Signature Telephone No. PERMIT FEE: $80.00 �� gg�� j Print Form ..4- oCEIVE 4,wnweaGth 01/fla.machuiette Official Use Onl I.'. �-=_sr e7 Permit No. .-3— —1 6 ! ,y AR 1 4 2023 f artmant of.}ire Serviced _�_�= Occupancy and Fee Checked BOARD OFJIR PREVENTION REGULATIONS [Rev. 1/07] -`^'5'It DING ut_rAK ME N` (leave blank) '; i oR 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: 3/9/23 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) 134 Route 6A Owner or Tenant Clever Siguencia Telephone No. 631 680-9724 Owner's Address 134 Route 6A Is this permit in conjunction with a building permit? Yes ! No Li (Check Appropriate Box) Purpose of Building Restaurant Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd n No.of Meters New Service Amps / Volts Overhead Undgrd No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install owner supplied fixtures 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. 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 Tot No.of Ranges No.of Air Cond. Tons No.of Alerting Devices 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 ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No. of No. of Heaters KW Signs Ballasts Data Wiring: g 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 ❑✓ BOND ❑ OTHER ❑ (S eci I certify,under the pains andpenalties o p ) f perjury,that the information on this application is true and complete. FIRM NAME: EAV Solutions, LLC l � LTC.NO.:860 Al (/ Licensee: Jeffrey Derouen Signature G. D¢2tkezekf.. LIC.NO.:22206-A 'If applicable,enter "exempt"in the license number line.) Address: 110 Hedges Pond Road Cedarville, MA 02360 Bus.Tel.No.:(508)245-7155 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt Lic.Te No. (781)589-5692 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. I PERMIT FEE: $ I