HomeMy WebLinkAboutBLDE-23-16015 6/8/23,7.10 AM about:blank
7k, Commonwealth of Massachusetts :-oF • Y ,
*., Town of Yarmouth
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ELECTRICAL PERMIT w.`.
Job Address: 896 ROUTE 28 Unit:
Owner Name: DEOLIVEIRA GERVANIO OLIVEIRA VANIA
Owner's Address: PO BOX 671 Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-16015
Existing Service Amps/Volts Overhead 0 Underground 0 No. of Meters:
New Service Amps/Volts Overhead 0 Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Remodel of rear unit&separate service
No.of Receptacle Outlets: No.of Switches: Generator KW Rating: Type:
No. Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA:
Space Heating KW: Heating Equipment KW: No. Motors: Total HP: Total KW:
No. Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of Devices:
Swimming Pool: In-Grnd.❑ Above-Grnd.❑ Hot Tub❑ No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System ❑ No.of Devices:
No.Air Conditioners: Total Tons: Telecom System ❑ No.of Outlets:
No. Energy Storage Systems: KWH Storage Rating: Security System ❑ No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment:
No.of Modules: Roof-Mount❑ Ground-Mount❑ Level 1 ❑ Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: June 8, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: WELLINGTON R SOARES License Number: 21075
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: HYANNIS, MA, 026011864 HYANNIS MA 026011864 Fee Paid: $500.00
Email: info@wrselectrician.com Business Telephone: 508-364-8723
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.
INSURANCE: L .-C, ok t q k\47 (t1(`1z'3
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Cealth of MassachusettsOfficial Use Only
7-- __ -= AY C 8 Z Permit No.:
._ _ 111 : ment of Fire Services Occupancy and Fee Checked:
Y ; 11 ;" QAROPREVENTION REGULATIONS [Rev. 1/2023]
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''"•—.'' _- AYNLN FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527 CMR 12.00
_ City or Town of: YARMOUTH Date: 5J /2.3
3 To the Inspector of Wires:By this application,the undersigned gives notices of his or intention to perform the electrica ed below.
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Location(Street&Number): 9jj t, ROUTE. Z Unit No.: .. U
Owner or Tenant: V Ki l l5k DE OI 1\!k 1 QA ail: I N FO@ W tt-SE1•Et-TR•I U Alai.CbM
Owner's Address: `1 L iull,_ 2.� Pho
Is this permit in conjunction with a building permit?(Check appropriate box)Yes tg No❑ Permit No.: •
Purpose of Building: Utility Authorization No.:
Existing Service: Amps / Volts Overhead❑ Underground❑ No. of Meters:
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New Service: Amps / Volts Overhead❑ Underground❑ No. of Meters: W
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Description of Proposed Electrical Installation: O)&{1 (t,f 1 tail S�1 Q,E11ODE.L OP UNIT #2 - �'
16107PALW its geOlVilt NM vlvDe.V(TioVIICi � 1Vlix.-= A-o 014 itt
Completion of the following table may be waived by the Inspector of Wires.
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No.of Receptable Outlets: No.of Switches: 1 Generator KW Rating: Type:
No.Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No. Water Heaters: KW: No.Transformers: Total KVA:
Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW:
No.Heat Pumps: Total KW: Total Tons: Fire Alarm System 0 No.of Devices:
Swimming Pool:In-Grnd.0 Above-Grnd.0 Hot-Tub 0 No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices:
No.Air Conditioners: Total Tons: Telecom System 0 No.of Outlets:
No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment:
No.of Modules: Roof-Mount 0 Ground-Mount 0 Level 1 0 Level 2 0 Level 3❑ Rating:
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy)
Date Work to Start:5 23 Inspeections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: Wong N Rp(1feS f,IaJytt tt n 111C A-1 ❑or C-1 ❑ LIC.No.:
Master/Systems Licensee: t1 LIC.No.: ' I 2I07�
Journeyman Licensee: t LIC.No.: 1 1374 13
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address:
Email: Telephone No.:
I certify,un t i nd penalties of perjury,that the information`' on this application is true and complete.
Licensee: Print Name: ��W IN V13)J re S'Oj)&.1 Cell.No.: 508 364
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INSURANCE C VER : Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee
provides proof of liability including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage
is in force and has exhibited proof f same to the permit issuing office.
CHECK ONE: INSURANCE BOND ElOTHER El Specify:
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: Tel.No.:
Signature: Email.: