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Home My WebLink AboutBLDE-23-005573 yt Official Use Only ... Commonwealth of ' '� Permit No. BLDE-23-005573 , L 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:4/6/2023 City or Town of: YARMOUTH LW I To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to�f rfo�r/m,�}the ele tr al work dcscri belo / Location(Street&Number) 332 PINE ST /` IVlV 1 i 1'1 Owner or Tenant Zes{ar1i��iLa. = Telephone No. Owner's Address 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 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners I oNf o.of De es Detection and No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: 1 Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other: Connection No.of Dryers 1 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.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: y g 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 F E: $50.00 " -7 r°` 5 I(l(z5 - 1lc._ ( Z c2k_i 'e,,z— i32*3 (eg ("Oral- 66- '( MAZE , .at 1 RECEly ED /� /, ryyj • - l ommonu�aaLth o�//lus�ac�xu�affs O :cial Use O APR !; M 25aParintant o/J`ira Serviced Permit No. i -- 6 ARD OF FIRE PREVENTION REGULATIONS ev.Occupancy and Fee Checked BUILDING DE�',"' MENT _ (leave blank) BY. ATION FOR=PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.40 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: YARIVIOUTH To the Inspector of Wires: By this application the undersignedl.ives notice of ' or her intention to perform the electrical work described below. • Location (Street&Nu er) � / 0 e Si Owner or Tenant t� Z ��`� h 0 Het et il !- ( e;601.4 I Telephone No. Owner's Address Is this permit in conjunction with a b ilding ermit? Yes E No rp P`',(C-ear.a (Check Appropriate Box) Purpose of Building I'`(.. Utility Authorization No. Existing Service Amps / Volts Overhead C. Undgrd E No.of Meters New Service Amps / Volts Overhead Undgrd No.of Meters Number of Feeders and Ampacity �Location and Nature f Proposed EI ctripal Work: . {� - f LS f)rt�_ S 004 L4 Si Vim/ ,/' 1 tve/SC y S / 'rec.- t k l «� t t s lt ' , c6sue. t Completion ofthe follawin tablefmay be waived by the Inspector of Wires. No.of Recessed Luminaires INo.of CeiI-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 'No.of Hot Tubs Generators KVA • 'SNo.of Luminaires Above In- No.of Emergency Lighting - wimming Pool ernd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets INo.of Oil Burners FIRE ALARMS jNo.of Zones No.of Switches INo.of Gas Burners No.of Detection and Initiating Devices No.of Ranges 1No. of Air Cond. Tonsl No.of AIerting Devices • No.of Waste Disposers Heat Pump[Number•Tons (KW No.of Self-Contained I Totals: Y - Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Municipal Local❑ Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of Heaters KW No. of Data Wiring: 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: Inspections 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 BOND 0 OTHER 0 (Sped I certify, under th ains and ties o ) f��ury�that the information on this ap lication is true and complete, FIRM N 1�:� E'C h c l LIC.NO.: /11 7C3-- Licensee: e1� Y fe-k-Lo Signature _- LTC.NO.: k 1 L. (If applicabl e r p c �{ exe'� y/Ltr the ice e r ne.) Bits.Tel.No.: . Address: 1 .[ IyV J *Per M.G.L. c. 147,s. 57-61,security ork requires Department of Public Safety"S" Aft.Tel No.: License: Lic. No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's a ent. 7 Owner/Agent Signature — -�� I Telephone No. PERMIT FEE: $ to