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Home My WebLink AboutBLDE-22-000727 Commonwealth of Official Use Only f � Massachusetts Permit No. BLDE-22-000727 ,' 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:8/9/2021 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) 25 AURORA LN Owner or Tenant ADAMS CHRISTINE A Telephone No. Owner's Address 25 AURORA LN,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: Replace bathroom fan. 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- 1:1No.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 Initiative Devices No.of Ranges No.of Air Cond. To No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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 leJsofri. ." &sIMesavea i(o/le�Mosr rekreefla Official Use OnlyCI �] J,., :,, --) ,, .tri.. Permit No. L2�-' d7�/ �•+ •- Occupancy and Fee Checked > -1 BOARD OF FIRE PREVENTION REGULATIONS cv a [Rev. 1/071 (leave blank) W 1 . PPLICATION FOR PERMIT TO PERFORM ELECT ICAL WORK (, ! c :z , All work to be performed in accordance with t e Mauaachuaetts Electrical code t CMR 12.00 uj ! Q i f 4SE PRINT/N INK OR TY ALL INFORM �f 2NI Date: ce 1----1 r City or Town of )G(h/✓IA(44 V/ To the 1 or o Wires: ., * is application the undersignedtesgoticeof "s or her intention to perform the electrical work described below. Location(Street&Number) a JO\ /-41, Owner or Tenant Telephone Na Owner's Address Is this permit is eonjupAllon witSa pern1t? Yes 0 No,4 (Check Appropriate Boa) Purpose of Buildingi (V&/ Utility Authorization No. Existing Service Amps / Vohs Overhead 0 Undgrd 0 No.of Meters New Service Amps I Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ateiviA k Jl i cletAA Completion c she,(o1Iotring K be waived by the I7eel Qt.Whet No.of Recessed Luminaires No.of Cel.Snap..(Paddle)Fans Tra rs Total No.of Ltrtainaiire Outlets No.of Hot Tubs Generators KVA No.of Luminaires swimming Pool Above la- ma.of tt:tsRrgeaeyF Lyme mad. 0 sLrad. 0 Bat/ery Uralts No.of Recepbck Outlets No.of OR Burners FIRE ALARMS INC of Zones Na of Switches Na of Gas Burners N .a and Initiation Devices No.of Ranges No.of Air Coad. Toot Tons No.of Alerting Devices 1 No.of Waste Disposers Heat Pump Blmitcv t-T��__��IKW_ Ne.o?Self-Contained Totals: T�T~��I . Detecdoneile_crtOrevices No.of Dishwashers Space/Area Heating KW Land 0Mnritv i:nzecti w �❑ ONa of Drye rs Wn 'AppNo.oor Equivalent 'Na erWaHi eaters KW '!Ya aNo of Data Whim ,T�Signs Ballasts .b pr _.2 i: *kat Beira ' : , Na Hydromassage Bathtubs No.of Motors Total HP No,of Devices or Eauiy • t OTHER: Estimated Value of Electrical Work Attach adaritienal detail((desired,or as rega red by the Inspector of Wires. (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 :1 BOND 0 OTHER 0 (Specify:) Icer ,Nader- , mad** ,, . of, , ,, .. : atm . .,:: ,... othk P& � t l/ 76 FIRM NAME: LIC.NO.: Licensee: .� ®I It�,.. C.NO.: ((fgpplkaabk. Ott license ,; ..., Brae. Bas.Tel.No.: Address: W • �4g C' (!N ► p I Alt.Tel.No.: *Per M.G.L.c. 147,s.57.61,security requires i ' nt of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below.I hereby waive this requirement. 1 am the(check one)D owner 0 owner's agent Chum Signature t Telephone Na 1 PERMIT FEE:S