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HomeMy WebLinkAboutBLDE-23-000556 Commonwealth of Official Use Only ' IL , Massachusetts Permit No. BLDE-23-000556 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:8/3/2022 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) 8 OLIVER ST Owner or Tenant HUDSON RICHARD P Telephone No. Owner's Address HUDSON DOROTHY W, 8 OLIVER ST, 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 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 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. 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 ❑ 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 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 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 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:$50.00 C.-Y . (5102)2 - ' Cessoesoridit4 Viamadutoth ����Of Only r - mokes Permit No. l.--L �. BOARD OF y and Fee Checked FIRE REGULATIONS [Rev. liU7j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Mt we*to be forthrtned in aceonbnee with the (PLEASE PRINT ININK OR T7'P Li Dater atr C�►or Town� 2_.- a,Y o °the h� ' .Tres: Byisc F or her intention to pertbnn the electrical work wed below: t (Street&Number) 4,0 I I'v e V OerewTusnt r Omer T ekpbone Owner's Address `�° Is Ws perm*la p,�_L u- Yes No Pr (Cheek Appropriate Dos Pinyon if K.Q 5 I G/1 !a Utility Anthorimidim No. Esiathig Service._.._. Amps I V s Overhead 0 Underd❑ No.of Meters New Service Angrs / Volts Overhead 0 E'er 0 No.of Melon Number,f Feeders and Asopoeity ,Leeatien sad Nf 's rifpf tinniest Work: 6 ACC C She LTs I tk L.,'t r a , '• s Cie be wa t Wok lisrazaraf rim rte.of Rammed Llandudno No.ofCdL.Snep (Paddle)Vacsr: 101(G�`S14 Nw.fLtnntmdee tlnNete Na ethic Tilts -ceseuts s KVA t�J�SGA�/Y No.of Linibaieee itemodog podtubera a lb.et t No.sdRerepteets Outlets Ns.sfOil Bunten 'FIRE AII.ARSiS No.of Zones 4No.rebates* .etRwlfdMa No.hems Dormers lakes&&Meet Pie.afros No.of Air Cad. T sfAierdK Devises No.of Watts Ilispesste Beal Paorp 1 i er�TMs !ICW o.o engined Na otTD� t i ' �r�'a. Appliance pate/Ana Huhn KW iiiito, a flierNo.of Doyen s[w KW No.or No. ICW � �r Waters BAN* Mr.Ilydroniassage Bathtubs No.of Motors Todd HP T , ..' Mti I4' or OTHER; EstimandValueof Electrical Work: 00 �d llf era bv the t r�`pq , Work to sStart �� d�' �try-1r Inspecticss*be requested In accordance with MEC Rule 10,and upon coup. INSURANCE COVERAGE: Unless waived by the owner,no permit for the pinfonnimce of dectricel work may issue unless the licensee provides p+oat of iitltdity insulance iundemigned ncluding that such ,iy, is in bee �s�l ofsame operation"coverage or its equivalent The CHALK ONE: INSURANCE :A BOND 0 OTHER 0 gilt►:) permitoffice. !ems ars�sr eaui a.. , ,_ �dad �«eolds.>,p ,,,kaae 1476.E dif e Sloatan y Lttw Na; • Boa.Tel.Ns.: Aeneas: 411f. *Per M.G. c.sat,i~37.61,securityvMkt k e p Alt Tel.No.: M.G.I.OWNER'S INSURANCE WAIVER I am Mare that the Licensee does nose+r the liability i a. by law By my signalise below I hereby w this requirement normally requitedWit. I ant dse(check anal Q moor ©i+wscs's sic Telatioot No. 1PERM/TM&S 1