HomeMy WebLinkAboutBLDE-002831 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-23-002831
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:11/22/2022
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) 16 PIERCE ST
Owner or Tenant PIERCE BENITA Telephone No.
Owner's Address PIERCE HERBERT B III, 26 PIERCE ST,WEST YARMOUTH, MA 02673
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: Completion of work started by others(Rough 4-20-22 on permit#E22-5889 CX by
owner)
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. Ton l 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 ❑ Municipal ❑ 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
CZ/z -�-e `�( (.iq -
5-0L :_ECEIVELi
--- 'I akehaweb Mid Unfit*
'.V 212022 Peen*No. e23_2S31
-- Occupancy and Fee Checked
,aINC ., PREVENTION REGULATES [Rev.1/07j (lervebteek)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
We:Maacktobp linanumbeerwidttieMrwd�e-Eteario 1CodeSW 1200
(PLUM PRIIVPIN INK ORTTPE INFLORM ) e: Ill . 11 2
Qq Tow or To of 7A V1nn.o L To the Inspector of Wlies:
By this epplioedm the mdeoyned C.e famden toprleaa dr electrical wart described below.
s tom .(Sind!Nambse) i 6,
Owner sr Teesat 11e(Ce tm>Ul! a. Telephone No.
Omeer4 Abloom
i Aim paned i mmijoinlbo .Milo Merril! Yes 0 No ® (Cheri Appropriate Be[)
►ewee of'dials P e.s l L j 1 o•\ Maly AdheeigNw Ne.
Eabd g Simko Amps I Valb Overhead❑ Usypvi❑ No.of Maras
j+[erjjtu[gp Amps I Valle Overhead❑ Cadged❑ No.ofMNas
NembretUoedm.and Ampsehy
W Nauw Psgoad UAekd MMbr "Ti kn t S Lk tie r t C o1/4.I v.w o'IC.—I-by cvre,5-
I�(J�Ciq 1 aAM(1l1 Wv1 Uf 1�1A W 6-10or .(Oo(M. , u );iHAc p otssec[ (4�2.0i z.
JJ comprole.aVAriAttr4r!Ike�frirom ,Ma e.elan%
Ne.of Neared Iaeewker N.',CAL./hop.op.(Peddle)Fans lTh aNf er TKVAT
No.sflamlaebo Owtleb No.allot Tab Gmentms KVA
No.of Luminaires sidauskl Peal Aide 0 la. ❑ rift Lenin!u
dsall. o'ed. Raurs[Mils
N..o(Rreplesb Oulkb N.efOr lowers FUtZ ALARMitale.e(Zaua
No.of t➢wYeim Ne.KGas lrafers No.
airDeledbo
haitketseLlorhos
No.efFegre No.a[Are Coed. oed No.ofAladr,Sevbes
No.'MediDiemen /MSv1"ifads IICw Rw . .
N..etDbYwrbees t I X Space/Arm KW Leal ❑Odua
No.ofDryers Heade,Anilines KW tearBy'
Ace enmity Kw 'Na or Mawr No. err Ib N
him
s Slam %a* DTsd of
MtNa.Ilydwmemsgs RatNob No.of Molars Told HP or
OTHER:
Amara alikke hiaall ftitareA er ar requared ey ae huproar glWi%
Estimated Value of Electrical Work: (When required by municipal policy)
Work b Stork ►hmmetireis be mooted in emordetoe with MEC RAO 10,ad upoe ceeepLoden.
INSURANCE COVERAGE: UAW waived by the owner.no permit Aar the pmitmence adectried work may teem tallest
the license provide proof of!Malty insurance including`completed operation"coverege or its rbe ital equivulat. The
undersigned certifies dad such oovenge is in tome,red hae sib biled proof of some to doe permit lasing office.
CHECK ONE:DIHURANCE,$9 BOND 0 OTER 0(Smelt:,
IweMiff end dMlartl'i Mettle dopoeneeMe Ali pliaidkeItsoewadcoo _is .
P®IMI MAAR -C Q e -+si\C IUGNO.: IL-CT 63-3
limner pc 111.11111111T ( i LK.NO.:
ire pibnib.err Neste ,b i rmha'lert .. _) les.Tel No t
Ad ge= 112 Lrlivl n•1 e,u)C �d� Air Tel:W.•
*Per M A L c.147,s.5761.decuelty requires Depraved of Public Sadly"V'Lucenr: Uc.No.
OWNER'S INSURANCE WAIVER: 1 as mere dad the Licensee/va net him the liability ineemoe coverage aoraerlly
requited hyA ra
y nelwebelow.1bady+rwethiscp�me•lamdr:( one)❑mien ❑arme'ssame
OwaselSfgtwere Tdle�e.s No. PER MI PEE:$
Ken Elliot
Senior Electrical Inspector
Building Department
Permit No. BLD 21-006397
Issue Date: July 28, 2021
August 1, 2022
Dear Mr. Elliot,
Please be advised that the electrician who worked under Ransford Bawa is no longer
associated with the electrical work being done at 16 Pierce Street, West Yarmouth, MA
02673.
Thank you for handling this matter as expeditiously as possible.
Sincerely, ,
41)4...le-g-
Benita Pierce
(Homeowner)
16 Pierce Street
West Yarmouth, MA 02673