HomeMy WebLinkAboutBLDE-23-003255 fa Commonwealth of Official Use Only
-fi- 11111:p Massachusetts Permit No. BLDE-23-003255
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:12/12/2022
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) 248 CAMP ST UNIT F2
Owner or Tenant FERNANDES MARIA H Telephone No.
Owner's Address 20 CAPT NOYES RD, 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: Kitchen remodel and add recessed lights. (UNIT F-2) -.. (
Completion of the followtfi able m fit'1 4aiy d y ire Inspector of Wires.
No.of Recessed Luminaires 22 No.of Ceil:Susp.(Paddle)Fans Tra piei,. ... •' r ° ,.,l Total
KVA
No.of Luminaire Outlets No.of Hot Tubs Generator 0) N4 4ii i VA
No.of Luminaires Swimming Pool Above ❑ In- ElNo.of Emergency b
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.o -
No.of Switches No.of Gas Burners No.of Detection and D
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/Alertine Devices
No.of Dishwashers 1 Space/Area Heating KW Local 0 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 LTC.NO.: 14763
(II 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: $75.00
44.X9ei vk fa/19lzz� �
r tt, J
R ' V E 1 CMIewnow M e7 Mos.i.N.th se Only
permit No, C c; >Z��
p �� ;221 "` °i '----;--
Occupancy and Fee Checked
Om Swarms
C l BOARD OF FIRE PREVENTION REGULATIONS Rev.1/D71 wve blink
suk`oiNG-
BY— TION FOR PERMIT TO PERFORM ELECTRICAL WORK
All wok lobe pertained in aecordmee with the hiesell selb Elcelried Co ).327 12.00
(PLEASE PRINT IN INK OR T P�� INFORA�fA�TT1- 1 Dates f I 2- 2—
City or Town of: <°" w) "J1 To the 1 of •
By this application the undersigned pin notice ofhk a her semen to perO m the electrical work described below
tandem(Sent&Number) .Li 1..ow'i f .c?, Z
Owner sr Tenant Tie Ne.
Owner's Mines
k Ak permit in eoedtoeedon a_bogie Feadrf Yee 0 No (Cheek Appropriate Sea)
Mkt of WNW PcQJ`j C(- 4A fl•Gt 1 Utility Authorize**Na
Eskliag Service Asps I his Overhead 0 Uad*d 0 No.M Meter
naijkaaligAmps / his Overhead 0 Widget 0 Ns M Mears
Number of Feelers sad Agnate)/ 1
Nolen of Proposed EAeeekdw�.� K-ale K.4Art oat►, 1 laze e. 5c'
G,i S, cl to c t9ck oLtskwct SLt YY
P Orioc ftes atekelltiletreeLtabh asy be inured by she fit rdWhw•
Ma.or
Ne.organised L ndsoires Ne..1Ce4Srp.(Paddle)Fags Tars TTKVVVAA
Ns MLamb ert Oogee Ai..of Hot Take Geann K A
1%.et Lombok., swimmingPod AS.,. 0 ter- 0 no.a►s ergeoey uplift
tonal erred, geMers_lies
Na.AReeeplaek Oulkb Nit.MOE Banters FIRE ALARMS sate.of Zees
Na.of gneiss Nit.ofGas OmenmIngelli &vkm
Ne,.fgents Ns.1 Air Cask Total ►Nit.1Msr Devine
YwMW. .S pseees fieet T "N.or:
T.udk :..i4
Ne.atD6Ywi oen Space/Are Haan KW Leech r Other
es.'
N..ofDryers Heathy Appliance, KW neemey
Ns al - or molest i
TNwdtib 1KW Ns M Mk of _ �
Hann Sign Muse T sr aetitt
Na.Itringmsoge Bat tub N..of Meters Total HP
OTHER:
Apace ekkieetd detail(fd.W d.oresrrqukedbvekbupeetorelWirea
Euimaied Value of Electrical Work: (When required by municipal policy.)
Work m Sart Inspections to be mgoe bid in.ccordauce 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 Scam pranks proof of liability insurance including`compleeed operation"coverage or be substantial equivalent.The
undersigned certifies abet mesh coverage is in force,and has exhibited proof of:erne to the permit issuing office.
CHECK ONE:INSURANCE BOND 0 OTHER 0(Specie,:)
/ osier ad efMleok*atikei limit eked ere Ale inniewime i hue and emcee
FIRM NAME: Qite+(" ei*3 El c.4-n ct ou,, UG NO.: /4 763-S
Unseen ' 9oolare (J $ ( •T"'"--- LIC.NO.:
Id' •_ ie y peuebt►gse) Bse TalNe.
Address: e 1 Z W i udtrepine iM a 1 PLiJ Ale TN.No.-
'Per M.G.L.e.147,.S7-1.eeeaaity Depetmmo of Public Safety"S-L.ioaue: Lic.No.
OWNER'S INSURANCE WAIVER: I am aware that the Lionise does In dew the liability insurance coverage riots*
remind by .By my sigreeeae below.I hereby waive the mgtatement.I ma the(check one)❑owner ❑owner's U*.
OinarlAgoat
Draws Telephone No. r PERMIT FEE:S I
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