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Home My WebLink AboutBlde-19-007065 Commonwealth of Official Use Only ..E. Massachusetts Permit No. BLDE-19-007065 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:6/14/2019 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) 168 CAPT NOYES RD Owner or Tenant HAYES EDWARD J Telephone No. Owner's Address 168 CAPT NOYES RD, SOUTH YARMOUTH, MA 02664 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 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service&install receptacles for washer/dryer. 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 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Inftiatine Devices 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 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other: Connection No.of Dryers 1 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 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: 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 d 4L ?((e it ( �✓ C,ommoetosa of t'/la�saclt _,_COfcial Use Only f sii / Jicparlmcs t o f Dirt Jarvic� Permit No. ��lQ I'(�P BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked . .: ' 1/07] (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK q ili CI r-- -"'1 All work to be performed in accordance with the Massachusetts Electrical Code ,5Z CMR 12.D0 '2(1rrEASE PRINT IN INK OR TYPE ALL INFORMA770N) Date: f 3 /9 z ' o I Cityor Town of: YARMOUTH To the Inspector of Wires:—i co X this application the undersigned notice of his or intention t dorm the electrical work described below. �-fi A cation(Street&Number) lCaret(K d ,e— S - U �-+_/ V _= 1 rer or Tenant G(� �wes V lli Telephone No. f i y•• er's Address cc is ibis permit in conjnnctioq'Ili a bail ' g permit? Yes �� ❑ No g (Check Appropriate Box) Purpose of Building fee Si d/ I'l Utility Authorization No. Existing Service Amps / Volts Overhead Q Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity jy Location and Nature of Proposed Electrical ork ` hee.,f,i .e_ ,e4-1.1,_e._ " oi0 yr 0"at woct4t1r riot to c) Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No.of Ces1.-Sus?.(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 It mergency Lighting - arnd. grid. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No. of Air Cond. 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 Local❑ Municipal Connection ❑ Other ,3 No.of Dryers Heating Appliances , Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent gNo. 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 tri al Work: (When required by municipal policy.) b Work to Start ' G I J Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless <25Th the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The c9 undersigned certifies that such overage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify:) •. I cemfy, under the 'ns alAs ofpe 'ury,Oat the information on this application is true and complete FIRM NAME: b to C►� oiler /S __ Licensee: C'� LIC.NO.: �(� (Ifapplicab "ex " Signa re LIC.NO.: `n he 'ce er line.f c: Address: (� Bus.TeL No.: J *Per M.G.L.c. 147,s.57-61,securityrequiresAlt.TeL No.: rk D agent of Public Safety"S"Lic e: 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. am the(check one) ownero Owner/AgentI ❑ 0 owner's agent ' Signature Telephone No. [PERMIT FEE: $