HomeMy WebLinkAboutBLDE-22-005990 Commonwealth of Official Use Only
.ter, Massachusetts Permit No. BLDE-22-005990
• 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:4/19/2022
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) 7 ORIOLE WAY
Owner or Tenant ROCHA KIMBERLY-ANN Telephone No.
Owner's Address 7 ORIOLE WAY, 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 for hot tub.
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
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 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 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: $65.00
02. A ti/ii /7-
RECEIVED ti g. OD
.A, -- daeowamaiL4114,10,4,-46 (Acid Use only
r , 'R 192022 Permit No. CZE-- 94o
— Occupancy and Fee ed
.S. if .INii0/ ePREVENTION REGULATIONS [Rev. }/�/) (lean b
lank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be pafa mad in a condo ce with the Mestechusetts Elegrioal Code ( MR,12.00
(PLEASE PRINT IN INK OR 'E WIN 1 Delft =/5 )- �---
,§
City or Town of: GVI ►'1�� To the , r, 4 , Wines:
By this application the , < ' ., girt .,.' ofhis or lea intention a pehrill rm the electrical work dsecnbed below.
Loam(Street&N ) al y ' ,
Owner or Teat t lM a ' 1 • J Al Telephone No.
'. Owner's Address
b 06 permit In esel .6nildieg Yes ❑ No�(Co eels APprop )
Purpose et R.IdIq LS i�)eZ the Na
• ,teeAmps / Vans Overhead 0 VediErd 0 No.of Meters
I Volts Overhead 0 Cadged 0 Na of Meters
Nabs of Feeders sad A.upneityr
Location and Nature of Proposed Detrital Work: LYA (, --OD
C.tIrelaa afhrjelloldia Illek lilliffbe waivedkr the!Tzar et Ifirsi
C. Na.Obsessed Lermiaalres Na ofCd4Sesp.(Paddle)Fay 'i'ramMrmers KVA
No.atimel.abe Oasaeb • Na of clot Tao Generators KVA
Na.of t.aetneres swiy.aahts Wel' 0
till. ❑ y�
Na.stampede Oatbb Na of OS Banters FIRE ALAR IN..of Zones
Pts of biters, No.of Cas Bunsen No.
)etesu
Ural '
on*ad
Lrtisa Davies,
Zc,,,
Na of Manges No.of Air Coed Toilet No.of Aler1YS Devine
No..fWasisaspen= 'Rest Pomp:1Iie1 1Teea 1'1 `' W� ybes
Na oto Spew/Area Heaths" KW Lad 0&I.14/10 Ober
Ns.of Dryas Appy KW lYe aEme rMdtt
Ka,arw KW Me.err � Date%Video
Silos t of 4r :.,;xu
No.Hydromentage Rasld.bs Na of Mean Total RP or
OT/IER:
cco Attackdk lfdtaired arm:+ aitr,bytee/uhpeciarq/Whys.
Estimated Value of Electrical Wade E" (When requt ed by mums*policy.)
Work to Stmt Inspections so be requested in accordance with MEC Rule 10,sed upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit ter the peribrman c of electrical watt way dente tratess
the licensee provides proof of liability y insw a including`completed open don"coverage or its substantial equivalent. The
undersigned cettiffes that such covagge is in fbroe,and hes ddtibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ®OND 0 OTHER 0 (Specify:)
r am t itl r ..et p the pa Ydt.pplk ttsn th true and airlift76 3
FIRM - k y LIC.NO.:
Lingua sperm AMR, . r--- LIC NO.:
1 2�sa h�'�r+lht� 7 U, �Tel.No.;
NNe;
*Per M G.L c. 147,a 57.611..security work rtquiros Ott of Public Safety"S"License: laic.No.
OWNER'S INSURANCE WAIVER: I am more that the Licensee dha trait heave the liability insurance coverage normally
ragweed by law. By my signal's below.I hereby waive this roesinmc et. I am the(check ons)0 owner 0 owner's meat.
Spam Owner/Ague Telephone Na I PERMIT 1E& $