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Home My WebLink AboutBLDE-21-007200 ��0 Official Use Only Commonwealth of Permit No. BLDE-21-007200 .E Massachusetts 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:6/10/2021 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 de cribed cribed l(w. Location(Street&Number) 9 MATTAKESE RD Cl N 1'_` i ti Owner or Tenant Telephone No. Owner's Address C Is this permit in conjunction with a building permit? Yes 0 No ❑ (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: Stove,cooktop,vent fan,dishwasher,&bathroom fans. 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- ElNo.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 ❑ 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 ❑ (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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 ,u,&a_ 730v lam-6i ixty j e A Co d&of mst(ilsm..tte ornci i Use Only `. Permit No. - —7 O f BOARD OF FIRE PREVENTIONOccu and Fee Checked _ ..REGULATIONS Rev. 1147j cleave blaaak) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ��✓�t p �Alll/.� INrork K b[e�performed s e n case ce with rhr a Massacl Ell y� l Cade( �. `)).J1s//yy�e�//c�tN R 12 00 (PL!4SE PRIN I17 Itch OR l ti` Ct L V"`hap N) Date: �8 c,2 ) City or Town of To the lmrspector of Wires: By this aPPliestiell the tmdealgtied ves»tics o . or intention to perform the electrical k described below. Location(Street&Number) 9 t4a r v ese- Owner or Tenant C RA S t t 4 A} G S Telephone No. Owner's Address Is this permit he essi I.der 414the Yes ,❑ No (Check Appropriate Box) Purpose of Building e91 Ck/hn Utility Authorization Na Erbting Service Amps / Volts Overhead E tarlitrd 0 No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and An/parity Loca a anti Nature of Proposed, Work: �jj Ht C -61.t (,vvt 'vim �1S It�L'e Proposed SAD Gu.� V -& y1�5) Na of Recessed Lumhaeires No.oiCe1 -Susp,(Paddle)Fans No.of �bt waived by the l�oJ'itrh�= T KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming PooAbovespit in tit-erritL [- rB dK No.ofReceptacle OutletsNo.of OM Barney; FIRE ALARMS 1 Bottery plaits Na of Zones No.of Switches No.of Gas Burners W000ilietediaa anti No.of RangesNo.of Air Con& Tom' No.ofAlerting Devices No.of Waste Disposers Toirds: 1 Dentetimitii_epilieg_Devices No.of Dishwashers Space/Area HeatingKW Coal❑ ingluncliPal 0 Other of Dryers Heating Appliances KW Security lva Wnter KW -Na of N or .. Bt eat l of DlY,' Heaters SignsBallasts o. Bathtubs No.of Mottors Total HP . T Na ' ,ir- kiltatt 11r �i i.. t OTHER: Estimated Value f .>• �#aa ek aatttaarri detail 'desired or as motored by the I r of Wires Work (When required by municipal policy.) Work to Start: b at Inspections to be/*wasted in accordance with MEC Rule 10,and upon completion. INSURANCE a :k: • Unless waived by the miser,no permit for the perfismance of electrical work may issue unless the licensee provides proof of liability insurance including`dated "cam or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the CHECK ONE: INSURANCE .� BOND OTHERpermit issuing office. I curt antler _ and :r 0 ( iR+e „_ 01• .nr Ode it as►e and complete. FIRM NAME: _ — t C ln�j, M LIC.NO.: / �1 `/�- Cheerier: �C „ . '- - Ql �Addmr f _I__ f i — Bass.Tel.No.: *PerM.G.L c. 147,s.57-61.security + requires Department of Public Safety"S"License: AFL Tel. No OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not hare the liability insurance coverage normally required Ow Aby la . By my signature below.I hereby waive this regnir�ein'tent. I am the(check one),0 owner D owner's hers, Suture Telephone No. I PERMIT FEE:$ I