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HomeMy WebLinkAboutBLDE-23-005819 1. //1 Commonwealth of Official Use Only ; �•,. Massachusetts Permit No. BLDE-23-005819 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:4/20/2023 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) 39 OUT OF BOUNDS DR Owner or Tenant MICHAEL HUSSEY Telephone No. Owner's Address 39 OUT OF BOUNDS DR, 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. 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 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 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 -� z743 e t I oilotai that* wz PR ' ChrliP otmy semi we Che ind p ffm °owebaettt 0 . , PERMIT TO PERFORM ELECTRICAL WORK . , ... . t is aeoordwneewigs the Mosidowass Skold cobs 1.52 MOO OO (PLEASEPRINT�Mr 0170,641. � R,s• p 4/ I/ z City orTo s G%L� w • To the r,.,> :k,. ofi ; By this opyliondon the todordined Own nodes orbit or so peribto the r week below. Localise( &Iwaoihee) 3 g ©L 0 t .I,c s , Omer orTema I"1 v-cue ( N c.ksce Tehyhooe No. Onsies Mims h Hale persnI la eselosedeo sl i Yes CI N. ' - (Cluck A Be.) roma.tom i " St 11 . ( USW Asdkorlassies Na t dosing Swab* A ! Van El lUndod 0 Ns.of Meson ISKIlkain __.. I veils Overbeed Q Undoird O N .oil . .:...._._, Nosaber of Radars sod Asap* Illsoliso sad Rowe of Proposed Ac t,e-, 5 ice.- - o . IteSseck L'I i t o%c-1 & - Z. i 5 to cJ 3 �-c r� s v��c r� il g s l�� kJ-Am= `�"c , y ,, t.kaui�st*t_bltos c 4 l' e was Ala afWhVR. „Y ati to■siaelsoe Oulkos No.OEM Tabs Gsseensees KVA atlandneino !ltet Q D rra►w filaddinsdy war t .tliea sit Oa** Nee of CI Rerun ARE MAWS Pie.oases* att[sslieMs Na atGoe Iu.asn Iiar Ites .tomes N..dAk Cad. raid 441...fM tlisSiorko No.illVielaDlepeeses lkstrirlp ipwarsrlyorpror N► - i t .,,a.0 ataldismiars Space/Ana tlenpeyt KW • 1:3 Q No.ofDom i� Kw ..._ -- - Y1R► ''44' Doss Widow eta Rauh T ( I' No.Etdoseesinage DAM' No.of Mars Thal HP ;� , it :, Atiackalikketal*WI realinut oresrris edbrtheh prebrgfl Eatitaged Vegas of gleacial Work Mee fectelai by .} West*Sat bepeolione so be re pnoted in acconknos with MEC Rale 1R,end upon ortnyletios. 1101 Um&NCR COVIERAGEs Uotiew waived by the owner.no permit for the perionnoose otaleaticai work n y tow unless the Room paddle oSatihb operation"coverage a or Its sabsttontid equivalent. The andoolosed*des h t east ,&, is is haute and has stcsiled;motet same to the pain#ingot office. CHECK ONE: INSURANCE .:4 BOND 0 OTHER. 0 (Spec*:) ofors I,eserior *pawl O the0.11t trontsk ukOw mad atoptiat c € -e-c -v%C- PIE,: I( 763 ..- Moms: ?.tom e te n t )---- LIC.le0.-T Aid J L . 1JV de*MnwawsM�rAo ,S Alt',Tel.No.:, `7-A/Z t 69'7�-y S *Per M ti le.c.147.a,5761. woxlt reQ Dwodanst of Pof Mile Bin,ir Geenee,. Lie.Na. OWNER'S INSURANCE Wank I ass*owe that the Lies=ems ass Roo do li ft boeatanee covowre noon* meld"s4 by low. By soy silasataro below.I bushy wai.s this sespaseseent. I owl* nsr Q iwerer"b amens. =Art T PM. ffiLWT •$ oVeC (AI°