HomeMy WebLinkAboutBLDE-23-005637 li\k-dCommonwealth of Official Use Only
- Massachusetts Permit No. BLDE-23-005637
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:4/10/2023
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) 49 MAINE AVE
Owner or Tenant JEFF MILLAR Telephone No.
Owner's Address
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: Install sub panel&wire ductless system
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. Ton l 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 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 Siens 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: $75.00
Official Use Ot fommonweald. al Madoachwettd
...6:Z3-- 37
Permit No.
.2epartm-en o/..71re Semiced
Occupancy and Fee Checked
\---- '''---1:::.•.'s BOARD OF FIRE PREVENTION REGULATIONS {Rev. 1i07] (leave blank)
CATION FOR P'It:_.:_i RN I TO PERFORM ELECTRICAL WORK
All work to b.:performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
.'RIAU lAr INK OR TYPE ALL INFORMATION) Date: V 1 i- 06- 2o23
:...._ty 0.1.7ow'ra G;f: \j/41 ;2-i'-'1 0 tri kr To the Inspector of Wires:
By ..-c.is -;:-.,-.,:ication the undersigned aives notice of his or her intention to perform the electrical work described below.
I_,. . .. -',,..et it. N.t.E:i..bi.f.; LH mod NE A-vE
t-'1 I L.L.PerL..- Telephone No. ‘03 321 0 46,r
ress
con .n.nctl-,n with a build in permit? Yes El No E (Check Appropriate Box)
. -2.tiiidTq..; Utility Authorization No. •
Amos / Volts Overhead Undgrd C No.of Meters
------- _
._.,,- .-'•_ . . _____ t, -=-1--ts____ L Volts Overhead Ell Undgrd E No.of Meters
oil'-,,:?ased Electric..., Work: IN,suil rz mot SA04\itl,tat TO EX1571116- pme,
wee siktitc oucttzss_asisTAIIED 51 oil
Completion of the following table may be waived by the Inspector of Wires.
--No.of Total
1 IN 6. IT/r*.‘.1.1 2 es s ed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA
,_
!le ef;,..-: .,•ii .irft 07.q.lett No. of Hot Tubs — Generators KVA
Above r--Tiit- I-7 -NOT&Emergency Lighting
..Z.L. ..,:linaires Swimming Pool grad. L—I grnd. 1--1 Battery Units
. 74_,..,epi:acle Outie-is No. of Oil Burners FIRE ALARMS No.of Zones
No.of Detection and
No.of Gas Burners Initiating Devices
.. _.. . Total
•
:‘,o , ; _,. -- es N . of Air Cond. No.of Alerting Devices
, Tons
-
TgearPuinp I Number 'Tons KW -No.of Self-Contained
:DiSposers Totals:al De,tection/Alerting Devices
I... _ . I--- r-1 IbluniciW r-,
Other
Li Space/Area Heating KW 1Local Li Connection
.- •-: , - floating Appliances KW Security gystems:"
No.of Devices or Eguivalent
N,-,. or- Wiring:
No.of Data
KW 1
.... Sikos Ballasts No.of Devices or Equivalent
!is•,,.•-_-.'%• . E:lassa ge 'F;athtLibs N3. Of Motors Total HP iTelecommunications Wirpg:
( No.of Devices or Equivalent
!i:: !'•.:.-,,:;-
Attach additional detail if desired, or as required by the Inspector of Wires.
'c.,tut of Electrica! \A'prk: (When required by municipal policy.)
_._...._.._._
Inspectic.-:s to oe requested in accordance with MEC Rule 10, and upon completion. •
,:.•.:-: . .. - ..-1.i-,CUli i;-...61/",.:. fs;: Unless waiv,.-A by the owner,no permit for the performance of electrical work may issue unless
r.:7.)vides frzoof -:f liability insurance including"completed operation"coverage or its substantial equivalent. The
cefies chat ...!(.;i..!coverage is ;, force,and has exhibit eti proof of same to the permit issuing office.
iNSURAr2,7-; il BOND EI OTHER E (Specify:)
l" --2,•is'i:: - 2.7filiiS(i.'i4 penalties of-;:?-pJ,,y, that the irformation on this application is true and complete.
_ L .-.)'-. R Soares, inc. d LIC. NO.: 21075A
kp.i c._____ _ r_ ..._. _
So _ r.7T-1.--/ares _ ::.;Iguatu
, / ),. ._ ,
....:.. LIC.NO.: 1137613
V:,_. , •. . ei;r-T .-') 1.di the !icense u,e..:)et ..; Bus. Tel No.:
'13.-',"-..iteac;s di!! Ra, unit D, Hyannis, MA 508 778 5936
Alt.Tel.No.:
774 836 5877
F. 57-r, security work,Le.,..ptires Department of Public Safety"S"License: Lie.No.
.' r•--,:,.1•', -, :',' S-r..)7!..',1‘7(.7!? 'VAIVEP.; I ...Ir.,. aware that the Licensee does not have the liability insurance coverage normally
ret.lt .---_-! '. . iaw. By ro.y s.iLmanlre below;I nereby waive this requirement. I am the(check one) LI owner 0 owner's agent.
_____ _ Te ne lepho No. PERMIT FEE: $ 7 ...
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