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Home My WebLink AboutBLDE-18-001772 J+p OffcialUse Only a Commonwealth of P Massachusetts Permit BLDE-18-001772 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.l/07j 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:9/26/2017 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. 1�(5 1 \°\ Location(Street&Number) 22 AUTUMN DR Owner or Tenant REYNOLDS DONALD T Telephone No. Owner's Address PO BOX 382, DENNIS PORT,MA 02639-0382 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd ❑ No. �/rri�` New Service Amps Volts Overhead 0 Undgrd 0 D e V Number of Feeders and Ampacity (\�7V `) Location and Nature of Proposed Electrical Work: Replacement panel,wire 2nd floor to code,replace re ` . cfTeli.r' ) Oy`sr Completion of the following table may waryltj2 / ;Mires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddie)Fans No.of �//n; o al Transformers �wLLLJ No.of Luminaire Outlets No.of Hot Tubs Generators (/i�,9 S M No.of Luminaires Swimming Pool Above 0 In- ❑ No.of Emergency Lighting i G/ grnd. grnd. Batten/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 0 Other: Connection 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 OTIIER: Attach additional detail fdesired,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: Peter Peto Licensee: Peter Peto Signature LIC.NO.: 14763 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 132 Wintergreen Ln,Brewster MA 026312258 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 signature below,I hereby waive this requirement I am the(check one) 0 owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 {?e oc E 221=L-iemit rz(n le 7 k- I �� it41q 6 (ars w O,aatans TvA +Mori • omm. raves Dim...„aci„.4,-fff ... .75. rte„ cc7� �7 Peradt No. ' Oa_.—‘*..,44"."-- ma- 1Jcpe tmcFJ 45.,..&sulci • Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS . )tp>) peavebink) ------ • APPLICATION F`OR;PERMIT TO PERFORM ELECTRICAL WORK All wort to be on-Donned in accordance with the Massachusetts Electrical Codd: ,C) T7J,P.I ID0 (PLEASEPRWT IN INK OR TYPE ALL IN _1 FORMATION) Date: zO 1� 0 '_ ! City or Town of: YARMOUTH Bythis a To the I etas o Wires: LJ M1application the Imdersiped givrs notice o bis or lam-intention to pelt=the electrical work described be w. >1 1 N Location (Street&Number) .2— �t� WI h or s• Yk cow_. I Owner'orTenant 6.I if 4- 1-----4 _ ktAec how �� Ll! h CJ Telephone No. f Owner's Address --� 11{! L cliff ,o Is this permit in conju on with a building permit? Yes ❑ NoTa (Check Appropriate �,i iE Purpose of Bwldtag _1 _ . . t PP Pfh%te Boz) cn m >Z�C �� 'inky Authorization No. I..-- -- Existing Service_ ,romps / Volts Overhead E. Oadgrd❑ No.of Meters _ New Service __ .Amps / Volts Overhead❑ Undgrd E Nb. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work - 2Vl�Q_ e 4 t YrCjct ' 9� �4* (Lc clip G� `�wP a �s— y"� lu s til \<tcc _ — - Completion of the fotlon inq table maybe we:bed by the Inspector area No.of Recessed Laminah-esNa of Cetl�asp.(Paddle)Fags INo.ofransiotmTotal.Ters KVA No. of Luminaire Outlets No.of Hot Tubs (Generator • KVA ' No. of Luminaires Swimming Pool "'hove In- INo.of r.mcrgeary Ling . Arad. et-nd_ Hats-ry Uni's No. of Receptacle Outlets No.of Oil Burner F=ALARMS INo,of Zones No.of Switnhe No.of Gas m :s B -as .No.of Detenaon and No.of Ranges Total 1nit3atmA Devices Na of Air Cond. Tons No.of Alerting Devices APRs Pump I Number Tons KW INo.of Self-(:oataiaed Totals: Deteetion/Alertino Devi No.of Waste Disposers ce No.of Dishwasher • Space/Arta Heating KW LocalMunicipal ❑Coanectioa 0 Other No.of Dryers Heating Appliances KW Security Sypstems:' No.of Water Hter KW Iigns Ballasts No. of No.of Data W Devtces or Equivalent SBallas t Na of Devices or Equivalent No.Hydromassage Bathtubs INo. of Motors Total HP Telecoinn:mai can ons Wirinv No.of Devices or Equivalent OTHER V M Attach additionl detail if derived oras required by the Inspector of Firer. Estimated Value?Elect; a1 Trot V(/ (When required by municipal policy.) Work to Stat 26" coons to be requested in accordance with MEC Rule 10,and upon completion INSURANCE COVE GE: 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 overage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: NSURANCE BOND ElOTHER 0 (Specify:) I certify, ruder arxd pewits FIRM N, : ��r ( ofP' •,that thetinforrp¢fion an this application is true and coin .: 1 I,t / "Ogg—, 1 O Sec41-,sl GI Q� LIC.NO.: I y / o.`S j Licensee: I t ' 6 Sign. • e l i�' L[C NO.: afapp icabl ter"cceenmt in Ali nue umb lin r . Address: ` �L W 11,1. N .$/r �I s er -Bus.Tel.No.:_ J "Per M_G.L.c. 147,s.57-61,sect t Alt. No.: work requires Department of Public Safety"S"License: Tel..No. ------ ex OWNER'S law.INNSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally SBy my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent , Owner/Agentg Signature. Telephone No. PERMIT FEE: 5