HomeMy WebLinkAboutBLDE-23-001597 Commonwealth of Official Use Only
L�f,'j� ', ' Massachusetts Permit No. BLDE-23-001597
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:9/27/2022
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) 8A&8B ROSEMARY LN
Owner or Tenant JOHNSON NANCY L TR Telephone No.
Owner's Address P 0 BOX 342, HYANNIS, MA 02601
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: Permit to close out expired permit(E21-3618)(UNIT 8-A)
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 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
Pondt No.
24,./.2.Selliali
A.
Oempency and Fee Checked N1/4 I BOARD OF FIRE PREVENTION REGULATIONS pas. 1/071 awe%mu --------
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
Aft work to be poribustad in aprordwee with the Moutitusehe ihastritui Code(MEC),527 OM MOO
(PLEASE PRINT IN INK OR TYPFAL INFORMAjtA) Date: 5/ .2_‘./2 2—
Cky or Taws oft M 714,7 0 To the hispeotor of Whys:
By this applied=the uncimmplives nodes afbis op.hawks to Pubes the siseericel%rah deeented below.
Leaden Oriel&Namiler) Ci? if KO Se:Wzovirle---
Owner or Tama
Telephone Ne.
01111.1•11•1••••••11•1110•NMIAIOMMINIO
Owner's Mina
b Ws permit in audeppees itM it .Imildbi permit? Yes 0 Na qt, (Cheek Appropriate Ilen)
Pewee et Masi mesigi F/T4-ti-o„ ) NSW Antimaindien No.
Itztaileg Service Amps / Volts Overhead CI Undims10 NIL at/Meters
$aw Benin Amps / Yells Overhead 0 Underd 0 Ns.ate
Number et preikes aid Mummify
Lewin ipad Naerimeeed thtetekal Wm* 19 0 Lt."- p &a5S
oftAo( i--A
Comdata,efohtkietrins 4?le waived by Wu hare Irma.
?kb.of lisemeed Limihmires No.arCetausp,(Paddle)Van ransinnen KVA
Ne.atLandsaire Owlets 14e.of list TAB Ginesibra KVA
N&at Laalnalres mese sn 1n. 0 611261101411401111
thelminand Peel mat U../ ad Jaipur,Deb
, ..
Na.et Recestaele Olden Ne.WS Sunken IlZAtARMe.Obelus
Omicron 1
Me.altSwitebee Me.ef Gas Swans
biltakatikalses
Phi.'Mew Ne.efAlr Cast TOW
TaoIN. efAksibre Derltes
Ne.'Mane Shrum itee9=1 Ininierfroms I it'W
I Alliki"
No.aiDidernarbers _Spece/Area Heath* KW ra1O t, " Cl 011ic
4..,-;.
Na.at Dryers UMW Appliances KW Ns ' ar Kailiekne ,
re&eirwaser les.er No,of Dia
Owen KW
Sbers Saban ,_4.4 ,
HP
N " ' .
Ne‘Hydrumenage Saebnie o.at Malan Teed A vow
or
OTHER:
&tack addittloal dotal 1 fasimit ores rewind hy tks/*paw eirtres
Estimated Value of Bectried Work: (When required by municipal policy.)
Work to Sot inspections to be nquand hi accordance with MEC Rule 10,sad upon completion.maamANCIt COvItRaGO Unkse waived by the owner,no permit Ihr the poibemimee°feinting work may imam unless
the limn pinvides proefriliabdiy insurance includinecompbted operation"wave or its seintantid opinions. The
undersigned certifies that=it 4, - is is twee mid has gabbed podof same to the permit issuing dike.
CHECK ONE: INSURANCE A BOND 0 onto. 0 (Specik)
I waft mew 0, ad 4, ,. drattheb.erreaden ere Mk qpirikadare Mae ant carplan 1 i , .1
puma h,-,06 "e-ro LW.NO» / "f / "
dirP
Meaner til,-.iimisrvi. .- 1. i.... IRVi4 Silaln1 1011Mte LC NO.:
—
toe w pnt o are Rue.T.I.Nei
I41 2-i& 9/6/ SANa /I44t eanem Alt Tel Ns:,e. 14TL 574 .secrityo Public Selby"Ir Limn: Lie.No.
OWNER'S INENtitANOI WAIVER: 1 am aware that the Unwise dooms haw the liability ineurance comer nonnally
rerpired lotlaw. By my igen=below 1 hereby wive this requirement. 1 am the(Ael ona)l;isivamr E3 ownees anent.
OwassfAspet
ramatitare—
Teladbene No. I MOW PEE:$
I
44,