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HomeMy WebLinkAboutBLDE-22-000728 Commonwealth of Official Use Only - Massachusetts Permit No. BLDE-22-000728 ��,,� �'; 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:8/9/2021 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) 1 LEEWARD RUN Owner or Tenant GIARDINO FREDERICK Telephone No. Owner's Address GIARDINO NANCY L,57 BLAINE ST, MALDEN, MA 02148-6203 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: Miscl.work per attached. 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 grad. 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. To No.of Alerting Devices 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 Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs 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 ❑ (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 my 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: $75.00 1'0V Cold8/ g7'74O-1 R-mae . RECEIVED ...__....._� t,nsinenevuof it el Moseackeedie Official Use only .` >4 202i : � t e/ Simko, No. ZZ�'7 ` 1 ° oc T Occupancy and Fee Checked .�'_ F FIRE PREVENTION REGULATIONS [Rev. 1/07j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK MI work to be performed in accordance with the Massachusetts Electrical Cade EC) 27 12.00 (PLE4SE PRINT IN INK OR PE ALLINFORM TON) Date: `LI 2 ) City or Town o1 Tyet �' To the Inspector of Wires: By this application the undersigned givej notice of his or her intentio9 to perform the electrical work described below. Location(Street&Number) J---e Lk,air di RC.t.M Owner or Tenant , 3 Cofp, Telephone No. ¢©3.313-S28S Owner's Address Is this permit In coniartioawith permit? Yes 0 No (Clack Appropriate Box) Purpose of Building K t C', I Utility Authorization No. Existing Service Amps / Volts Overhead 0 Vudgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Amity iLoorto a N re of Ekctrieal Work: � � N A,� (l.` Pns]u(eii at�� JJ("�"�►1 t, u)(4--c s J Conies (elite/of s ,be waived fee lavecior No.offor le 1!f oftl liens. Recessed Lug No.of CeiL Snsµ(Paddle)Fans Trttratars KVA No.of Leemiaaire Outlets No.of Hot Tubs Orators KVA No.of Luminaires Swimming Pooh 1 ❑ No.of lLigiltiog eptiell Mika No.of Receptacle Outlets No.of Burners FIRE ALARMS f No.of Zones No.of Switches No.of Gas Barriers No.?Dfetection salt Iaidat as Devices ,eta of Ranges No.of Air Coal. Total om No.of Alerting Devices No.of Waste Disposers Na�ber, o ITV Tends: __w No.of Sell-Contained___� ' Beteg Alerdat Devices No.of Dishwashers Space/Ares Nesting KW Local 0 MM I 0 Other rity nems:tt" No.of Dryers Henry Appliatsmes KW o.of ices or Eani►ahent No.of Water KW No.of No.of Data Wiring: HastenSign Ballasts Ne.of Devices or ri , t No.Hydronassage Bathtubs No.of Motors Total HP T M t OTHER: Amuck additional detail ifdesired,or as required by the Inspector of Wires Estimated Value of Electrical Work: 0r 500 (When required by municipal policy.) Work to Start: 0 6/O5 2l Inspections to be requested in accordance with AMC 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 has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE nit' BOND ❑ OTHER 0 (Specify:) qfg' itiory(,AN the alegion On this(mikados is to ii , FIRM eLns Me iIC.NO: 76 Signature LTC.NO.; onTexertiiAddrenu llc+e a number line'.) 5 11�c>S ) 8 .Tel.No.; *Per M.G.Ltrapplicablf e. 147,s.S?-a5t,security Alt.Tel.No.: ty 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 AgentSignature ! t�owners agent Telephone No. I PERMIT FEE:$ - 9,-,Z6 I