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HomeMy WebLinkAboutBLDE-21-003618 \� , � ` � Commonwealth of Official Use Only ��. , Massachusetts Permit No. BLDE-21-003618 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:12/31/2020 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his of her intehtwn fo perform the electrical work described below. Location(Street&Number) 8A&8B ROSEMARY LN Owner or Tenant JOHNSON NANCY L TR Telephone No. Owner's Address P 0 BOX 342, HYANNIS, MA 02601 � A� Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) )(1;� 7 Purpose of Building Utility Authorization No. 71 s 3`7 ��fU t ji4 (){ Existing Service 100 Amps Volts Overhead ❑ Undgrd 0 o.of Meters 91q1 f1 New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Service change,wire 4 receptacle, 1 Iight,1 smoke detector, & 1 exterior light. 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 r J. KVA Above In- No.of Emergency L' h . .:'° ,, No.of Luminaires Swimming Pool ❑ ❑ g y � grnd. grnd. Battery Units a. No.of Receptacle Outlets 4 ^No.of Oil Burners FIRE ALARMS N .of nes r" ' '"t r 5 �, No.of Switches No.of Gas Burners No.of Detecti a F' -, o �;"^,, Initiating De c u , CP' Total ` ` •©v No.of Ranges No.of Air Cond. Tons No.of Alerting D 'ces�<O 18,2� No.of Waste Disposers Heat Pump I Number Tons KW No.of Self-Contained ��'ej$' Totals: Detection/Alertine Devices \�F�•.''N No.of Dishwashers Space/Area Heating KW Local ❑ Municipal n is lion 0 �'Qther:C 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. PERMI FEE$75.00 (4 0 aeti (2.4 0(21 /' / 4 --\ Commonwealth-o/Mamacku..0113 Official Use Only PermitNo. 75 (,> v 2eParfinenf ol ire Servicea - - Occupancy and Fee Checked BOARD OF FIRE 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(Iv1IC),527 C 1 (PLEASE PRINT IN INK OR Typ ALL TION) Date: G 2 Jn City or Town of: rY �j'� To the Inspector of fires: By this application the undersigned ves notice of his or her intention to perform the electrical work described below. Location(Street&Number) A— .3 R O S e-V1A Ol. I-4/N , Owner or Tenant Telephone No. Owner's Address Is this permit in conj lion` ' h a buil�igg per? Yes ❑ No (Check Appropriate Box) Purpose of Building �� i Gl, Utility Authorization No. Existing Service./O v Amps +fn20 / olts Overhead m Undgrd❑ No.of Meters New Service 0 0Amps b L.v / Volts Overhead p 1 Undgrd I 1 No.of Meters Number of Feeders and Ampacity 1 Location a Nat of rop id a le�ctric Work: s (,� e/i' i !a pla8s' i� S r ' U Completion of the following/table may be waived by the Ins ector 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 Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grnd ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners IF[RE ALARMS No.of Zones INo.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: 1Detectio Munici aDevices No.of Dishwashers Space/Area Heating KW 'Local❑ Connection ❑ Other Heating Appliances KW Security Systems:* No.of Dryers No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lectric Work: L, V (When required by municipal policy.) Work to Start: I nInspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO ERA E: 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 BOND ❑ OTHER ❑ (Specify:) I certify,under the -ns and psg, I' s of perj �that th inforrltatipn on this application is true and complete. y‘3 1 FIRM NAME: ‹ �� aM LIC.NO.: ` Licensee: Sig ture l LIC.NO.: (If applicablt1r"eztn�j'i in� e z number line.mi 7�,VJ Bus.Tel.No.:_ Address: w i k Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,securi 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. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature _ Telephone No. PERMIT FEE: $ t e