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HomeMy WebLinkAboutBLDE-21-007526 co fACommonwealth of Official Use Only IL_ - Massachusetts Permit No. BLDE-21-007526 .017 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perfomied in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT/N INK OR TYPE ALL INFORMATION) Date:6/27/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 204 ROUTE 28 Owner or Tenant North Eastern Conf.of SDA 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 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Change plugs&add plugs 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. 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 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 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: $80.00 K\ip.. 6( 15P(2-1 Aoutreb. (9/m151, s-11v_ Mr- -l© 'et) -)/ mac. te. __, n tf �it e f Memeaelmseelh Official rUse t. ._. of t� e� � � Permit No. L '(tel — `9rW � ' lJeloavlawr�f e�.,�lfi�r�.7etviae ! 0» ' , ; BOARD OF FIRE PREVENTION REGULATIONS... _.,..„,, \ ,: -• Occup and Foe Checked [Rev. lro7j (km blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK i ,_ i MI wort:to be performed in accordance with the Massachusetts Electrical Code( ' 7 12.00 (P�,E�lSE PRINT'IN INK OR TYJ'�AI.L INFORMA N) Date: 6 . L ( '' - City or Town of IGC To the 1 , ctor of ires: i `; t:Hy this application the undersigned fives notice of hisAr her intention to perform the electrical work described below _ (Street&Ntaraber oL - _ ` -@edser or Twat NO'Y FA, 6O OA Ge— C>-(— Telephone No. Owner's Address SO> Ai— ls this permit in coakm3,thsa with a beading pipit?! Yes 0 No (Check Appropriate Box) o pyof gamier (441/14.01—C /el,I J"t Utility Authorisation No. Existing Service Amps I Volts Overhead 0 Undgrd 0 No.of Meters . Amps I Volts Overhead 0 Undgrd❑ Na.of Meters Number of Feeders sad Ampacky Location and Nature of Proposed Electrical Work: - ♦ -/ Cj S ,5' Completion elite followinktabk sew be waived by the!wave 4Wirer. No.of Recessed Lusainaires No.of Cel.-Sasp,(Paddle)Fans No.of Tntmers Total KVA No.of Lumiwdure Outlets No.of Hot Tubs Generators KVA No.of LeatindresPod Above la- No.of tomorrow upon gwimm . grad, ❑ gruel. ❑ Battery Units No..f Receptacle Outlets No.of OB Burgers FIRE ALARMS iNo.of Zones No.of Snitches No.of Gar Bunters No.a alhemices No.of Ranges • No.of Air Condi No.of Alerting Devices Tons No.of Waste Disposers INeat neap T Nig nI „T.,, _.,jV__.. N oats ed ' No.of Dishwashers Space/Area Heating KWLoral jJ Mn paltra 0 Other No No.of Dtyers Heating Appliances KW 5ke � o.1 *aleat Noo..Nater , y Wiring:No.of No.of Data Heaters Signs Ballasts T J of D vim pr ,`i►valent No. Bathtubs No.of Motors Total HP No,of Devicesor Edtuiv at OTHER: Amick additional detail(fdesirea oras regxbrd by the Iriper 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 is in force,and hm exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I dui, ►}� , of 4��EiT lb malio a ea this , ,,. , , is true and eodnplena 14163 '3 FIRM N- . : `l4 C-1 ..v Ns A► LIC.NO.: Licensee: , ' e ' rd, Sipuat A R'/'...-' LIG.NO.: ((fqq I moble .i li . JP Bus,Tel.No.: Address: [J�� � �^ ' �' ` _> Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security ' e res Depnt of Public , - "S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nal have the liability insurance coverage normally requited by law. By my signature below.1 hereby waive this requirement. I am the(check one)❑owner 0 owner's agent Owner/Agent I PERMIT FEE:$ Sputum Telephone No.