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Home My WebLink AboutBLDE-23-005950 ' 1/ ' Commonwealth of 14 Official Use Only Permit No. BLDE-23-005950 po-i � , Massachusetts F 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:4/27/2023 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) 76 SWIFT BROOK RD Owner or Tenant ROBERT STEBBINS Telephone No. Owner's Address 76 SWIFT BROOK RD, 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 ❑ No.of Meters Number of Feeders and Ampacity .Location and Nature of Proposed Electrical Work: Wiring of addition. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 1 No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emere•r icy Lighting grnd. grnd. Battery Unity't No.of Receptacle Outlets 6 No.of Oil Burners FIRE ALAR)}S No.of Zones No.of Switches 2 No.of Gas Burners No.of Detect,.o1 and Initiating Devi.. ,• --i No.of Ranges No.of Air Cond. Total No.of Alerting D> ices l No.of Waste Disposers Heat Pump Number Tons KW No.of t.N.:*` ..tamed _- — *A.---"`.1 Totals: Detection/Al .rtine Devices , No.of Dishwashers Space/Area Heating KW Local 0 unicipal Other: onnection No.of Dryers Heating Appliances KW Security Sys ems:* No.of Devic•, or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring:`, Heaters Siens No.of Devices _'val it i No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.ojevices oruivalent 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 Lilo 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: Stephen M Peckham Licensee: Stephen M Peckham Signature LIC.NO.: 17326 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 367,CENTERVILLE MA 026320367 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. 0. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 , 2ems, ;r- ` 2 1 2 ,s. civi4_ to'lgos, - .,,, a.. k, , P 7, I t F D (.ommontvealth of Maddachudetid Official Use Onl •t r,IAgt 2epariment ol..7ire Serviced Permit No. 1.c Z-� —�� • B I►ARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked »JILDING DE • , [Rev. 1/07] leave blank By -- ' ' D . A TION FOR PERMIT TO PERFORM ELECTRICALJ All work to be performed in accordance with the Massachusetts Electrical Code(ME 527 C . WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: BARNSTABLE 1 ctor of Wires: By this application the undersigned gives notic of his or her.' ention to perform the electrical To e work described below. Location(Street&Numb Owner or Tenant � L t� lV_ �� Ma Parcel# Owner's Address ► �C w �' Telephone No. Is this permit in conjun ' n itt buildingpermit? Yes �� No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd ❑ No.of Meters • New Service Amps / Volts Overhead Number of Feeders and Ampacit 0 Undgrd ❑ No.of Meters Y Location and Nature of Proposed Electrical Work: M • i j Com.letion o the ollowin_• table may be waived b the Ins,,;: No.of Recessed Luminaires No.of Ceil.-Susp. `o.o p (Paddle)Fans Transformers No.of Luminaire Outlets No.of Hot Tubs Generators No.of Luminaires Swimming Pool rnd.Above ❑ In- No.of Emil, eney Ligh, No.of Receptacle Outlets rnd. ❑ Batte Unit , No.of Oil Burners FIRE ALARMS ...... No. No.of Switchesof Zones I, A No.of Gas Burners -No.o I election and No.of Ranges otal Initialing Devices No.of Air Cond. Tons INo.of Alerting Devices No.of Waste Disposers 'eat at mp Number ons + '`o,o SKII ZTnin- No.of Dishwashers I Detection/Alertin_ Devices Space/Area Heating KW Local❑ Municipa —�,� No.of D ers connection ❑ Other Dryers Heating Appliances KW Security Syste;�[s:* ` `" `o.o `ater No.of Devices or E uivalent Heaters KW o.o O.o Data Wiring: Si ns Ballasts No.Hydromassage Bathtubs No.of Devi es or E uivalent 4 No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E•uivalent Estimated Value of Electrical Wor q...5, Attach additional detail if desired, or as required by the Inspector of Wires. Work to Start: / t (When required by municipal policy.) ,and upon completion. INSURANCE nsp'ct ons to',e requested in accordance with ME C RANCE COVERAGE: Unless waived by the owner,no permit for the performance lof e electri al work may issue unless the licensee provides proof of liability insurance including"completed ope at'• •• -erage or its substantial equivalent. undersigned certifies that suc overage is in force,and has exhibited r, q The CHECK ONE: INSURANC p ' °to the permit issuing office. I certify under BOND ❑ OTHER ❑ (Sped I, ains nd pen s o p rjury,that the informatio ' ,,lication is true and complete. FIRM NAME:, Licensee: u �I. LIC.NO.: + Z?j ` �,f Signature ,,,A0._- ''(lfapplicabte,{,entprAxem,t"in ��`� LIC.NO.: Address: f _' x t i{ lice's number1. e.) 1111. A t/lr,i I i';' / Bus.Tel.No.• 1.511,i►d e °*Per M.G.L.C. 147, 57-61,securityAlt.Tel.No.: ork requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVE': I am aware that the Licensee does not have the liability insurance coverage required by law. By my signature below,I hereby waive this requirement. I am the(check one ■ owner ,`. Ownred ent normally ,. " "" , Signature � owner's a � !!!I►P. Telephone No. PERMIT FEE: $ 7$'4`y 4 A separate permit is required for the InRfAIlAtlnn I1f cmnlra ilnfonfnre Giro p1,,,,„; ,;��__-_ _ ,. �_