HomeMy WebLinkAboutBLDE-23-002669 as Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-23-002669
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.I/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:11/15/2022
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) 169 SEAVIEW AVE
Owner or Tenant BILL McCORMICK Telephone No. Ai n jf1��_"
Owner's Address I..'"�AAt)l ���W4!-4ci✓(,i
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No. 10 6 23
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: Change meter socket to 3 meters and add cottage to separate meter location.
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 ❑ 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 ❑ 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
:
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[ V E D Cr Permit No. 3- (4`)/
13 ( _ • FIREIRE PREVENTIOZpagami N REGULATIONS a and Fee Checked
Swag
`'�� 2 [Rev.Iroaj (kin blank)
Buil.° -' ''•+_ 1 • FOR PERMIT TO PERFORM ELECTRICAL WORK
uv ,, , to be pertbeted in aemrbrcs with tie Mwd•uett.Boarial Code( CMR 12.00
(PLEASEPRINTININKOR ALL INFOR ON) Dste: III4G.z2
City or Towo o , (W l O �('� To the Inspector of Wires:
es:
By this eppliadan the gm modes orbiter her intention to perilann the electrical work described below.
L calss(Street&Number) (6 3 SCA, Vi C 1.4,k -fT L
Omer srTensest 'l I/ 11C64.1I'VM(C- Telephose No.
Owner's Maus
Is this perahl In ss gnat sm. •Me permit? Yes ❑ No El, (Cheek Appr anise Ha)
Parma ti .Nag ResIG-eMtGi 1 Utility Aatiorkuitioa No.
>=_ )d gimp. a.)I. -4 Volts Overhead E. Dotard❑ Ne.eI Meten
Asps t volts Overhead 0 Visited 0 Ns.of Meters
Number
nmolN naofPrs sad nprtity
ased i r `)(Lot
iweaW...drMlmrsdPrmpea.d6MeMealW.rfm tri�a.Vl I'YIe�� 3 ►� -Xl
ad& Co e_SeiNiC e--4-6, rrNe;fi4:r
cook**of**kwklettC�rD'te waged brdw ArtDtaywofWbrr.
Nov of Nee seed Iamsualeee Ns of Ce1LBrp.(Paddle)Fans 7Tf►•T U C�s�A.
No.at Lamaist Order Nov MHO Tit Generative KVA
Ns.sf Lmalnmbes swimming
Poi Alma O lir 0 U>s•i T upon
Nu itaerepuce Outlets Ns.MOB Burmese FIRE ALARM No.of Zones
Nov of Switches No.of Gas Bowan No.
sr Detallon sad
Wad's Devices
Nov atltsa.' Ns.OAS Card. Tend
: Ns.sf Mardrta Devices
No.of Waste Dkpssers Heat Pays ftssigg__���C_ra��1�KW_ Ns.KBelFC stained
Tara: Deftetk i lehsa
Na sf D6lewmsYns Space/Ares Hating KW Luc 0pi."7,vits0 Other
Ns sf Dryaes Hating Appliances KWNe.of= r EaNemlemt
Aiw dallier
Hatrs KW Sias jets or Ns.of Data Ds n or WirMent
Ns.lbs6measmae Hathenhe Ns.of Mstsn Teti HP T
w Nos K Devices or F.amklltnl
OTHER
Attack ad#daral dead((desired ores required brthe tagecwrgfWand.
Estimated Value of Electrical Work (When required by municipal policy.)
Work to Stest hspectioes to be requested in•omrdrroe with MEC Ride 10,end upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance ofelectrical work my sae unless
the licensee provides proof of liability insurance including`bompleted operation`coverage or its substantisi equivalent.The
kodertithued certifies that such coverage is in force,and hem exhibited of dame to the permit issuing office.
CHECK ONE:INSURANCE ISis BOND 0 (TIMER 0(Specify:)
/twegy,maw aryamsYMy Yut the itO ereadatmi iepp&nNsrstbwesalanpdds
FIRM � o k i n C:1 WA Lac No 1 47 G 3-'b
Llr� 0`�J Tel. NO:
�ppttaeb�a, le As►J II . ga►TsL Nw �t f4 1 1 6-g ((4S
ddreae l [i/t�U l�I Ale.TeL Nw:
*Pa M.G.L.c.141,s 57 61.scearity requires Depaet:rat of Public Saha"S'License: Lic.No.
OWNER'S INSURANCE WAIVER: 1 am more that the Licensee does sot bone the lability insurance coverage normally
tequad by law.By my Swan below.I husky wire that raft.1 am the(nark cm)El owes 0 owners Meat-
S •d T No. I PERMIT FEE:S