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Home My WebLink AboutBLDE-22-004322 Official Use Only Commonwealth of = taw . t1.4\ /*/e Permit No. BLDE-22-004322 71 �� ,/ j M assachusetts 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:2/3/2022 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) 664 BUCK ISLAND RD Owner or Tenant Thomas Peck Telephone No. 8606176147 Owner's Address 664 Buck Island Road,West Yarmouth, MA 02673 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: Miscellaneous work per attached. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 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 4 No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches 1 No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. TT ootal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons ) KW No.of Self-Contained Totals: Detection/Alertinu Devices Space/Area HeatingKW Local ❑ Municipal ❑ Other: No.of Dishwashers P Connection HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent No.of Motors Total HP Telecommunications Wiring: No.Hydromassage Bathtubs No.of Devices or Eauivalent 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: LIC.NO.: Licensee: Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line)Address: 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) ❑ owner 0 owner's agent. I , Owner/Agent .711: S, e Telephone No. 'PERMIT FEE: $75.00 '-' -'-"'`': -3/i‘/ikV S 3 PIN-0�rr✓rt�t Car,mu L► J QI 1 t A' �' '--l (0127_. tvr ‘(-14 / ._. RECEIVED .0k, ofl3ciai use a ny ----1 . FEB 0 3 2022 .. a ptricsdPermit No. ZZ—`f vv , `` i' - t . e S r"1/4i I N G DEPARTMENT Occupancy and Fee Checked f 4. �. --:.-c-,- PREVENTION REGULATIONS [Rev. 1/07} (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.90 (PLEASE PRINT IN INK OR WE ALL ORMATIOPtl} Date: i/2 /2 2 o City or Town,of: ¢IPA elk t h To the',vector of Wires: L..> By this application the undersigned gives noticeof his or her the electrical work described below. l ' f n Location(Street&Number) 6 b 4 tic/i 1<-,4'�( d � ---z> Owner or Tenant ''', 1ec Telephone No. Pro (j7 g'j(I 7 Owner's Address 4 r 4 &a cA (1dt±l f"Y C' is this permit in conjunction with a building permit? Yes Ej Nq D (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 101� Amps 120 /2.4 b Volts Overhead Undgrd Li No.of Meters QJ New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters l Number of Feeders and Ampacit�y , Location and Nature of Proposed Electrical Work: Aunt re60vci tf, c .' q rcti CJu#ff. O4 4e it -' Aimkj 20 q i,t p C(rat l ►'i tv cfatLi i f qct`rl/ ). 601‘ f h, a it e , ) -to S f 01174).14 C c of 1��# AC ��c�c�t Completion of the following table may be waned by the b5oector of Wires { Total No.of Recessed Luminaires No.of Cell.-Sasp.(Paddle)Peas Flo.of Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- 0 `N-4).at bntergen�eY Lighting rnc1. crud Battery Usli No.of Receptacle Outlets 4 No.eon Burners FIRE ALARMS No.of Zones l No.of Switches 1 No.of Gies Burners moo*of won and Initiating Devices 11, No.of Ranges No.of Asir Coati, Total o � No.of Alerting Devices No.of Waste Dbpose:rs Heath. Number Tons : .�.KW No.of Self-Contained Detection/Alerting Devices nicipal No.of Dishwashers Space/Area Heating KW Local[jj C need° Q Eimer No.of Dryers Heating Appliances KW S No.of Devices or Equivalent No.of Wafter No.of No.of Heaters Signs Ballasts Datallo.of or Ivalent No.Hydromassage Bathtubs No.of Motors Total HP ' "e]eeo so r El iv No.of Devices or Equivalent 1t)THER: 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: Inspections to be requested in accordance with IVIEC 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 inchrding"complete 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. Sce. CHECK ONE: INSURANCE 0 BOND ❑ OTHER C3 (Seifr) I rertify,under thepairss and pentftofper}wy,that the information on this application is true and complete. FIRM NAM IE: 7-7imi,i s � LIC.N0.: Licensee: Signature ' -1.v LIC.NO.: (If applicable,enter"exempt"in the license nu her line) Bus.TeL No.: Address: G(H toted° J5-4,1,4 Alt.Tel.No.: *Per M.G.L.c. 147,s.. 7-61,security work requires Department of Public Safety"S"License: 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. l am the(check one)�]owner 0 owner's agent. Owner/Agent Signature Telephone No. 1 PERMS"'FEE:$