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Home My WebLink AboutBLDE-18-6256 or 4 Commonwealth of Official Use Only I ApirPermit No. BLDE-18-006256 IL. Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked f Rev.1/071 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:5/8/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives no ice o is orher in en ion o per orris tee • ca work described el4,.°Location(Street&Number) 54 SCHOLL AVE (Z.f, /NV eCQL.LjNeVf Owner or Tenant QUINN JOHN E ESTATE OF Telephone No. Owner's Address MCGUINESS ANNE J EXECUTRIX, 16 SUMMIT RD,NAUGATUCK,CT 06770 Is this permit In conjunction with a building permit? Yes ❑ 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: Replacement furnace 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 1 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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:' No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts 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 ❑ OTHER 0 (Specify:) I cert)",under the pains and penalties of perjury,that the information on this application is true and complete FIRM NAME: RICH M MELVIN Licensee: Rich M Melvin Signature LIC.NO.: 21829 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:8 REARDON CIR,S YARMOUTH MA 026641207 Mt.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 signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. 1� PERMIT FEE:$1l50.00__ %1?-71- IN Ago,r 'Fox ox Wn ConbtlirppDJzr) 6�/3($ . > Cath E/ape Qi 2),vrq 9 CCommonwealth.mmonweag� ol rr/�//�aelachuIIdetf5 Official Use Only ommonwealth. Permit No. /62-6TCp je5 2apartment of"Ira Serviced € ___r t =-,� Occupancy and Pee Checked a„ •,.t BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 C e122..00 (PLEASE PRINT DV INK ORT EALLINFO T O Date: 055 OR/6 City or Town of: r N or p d) To the Inspector of Wires: By this application the undersign d gives notice of is or h r mtention to perform the electrical work described below. Lbdation(Street&Number) re S g * A• — Owner orTenant I, a It UM a - Telephone No. .s(S . 315 Owner's Address I In .0 )t71(Y1 I• •. a I_AOL I K - • n1,277n Is this permit in conjunction with a building permit? VeilNo ❑ (Check Appropriate Box) Purpose of EuildingUi )P I � Utility Authorization No. Existing Service_ Amps ' / Volts Overhead❑ Undgrd❑ No.of Meters ____ C ' New Service _ Amps / Volts Overhead❑ Undgrd❑ No.of Meters ____ Number of Feeders and Ampacity y� -� Location and Nature of Proposed Electrical Work: G QS ?U(YID R(��ce'r / e n l r Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers INA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Wove 0 In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas Burners No.of Detec and No.of Switches InitiaatinggDevices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposerseat ump _ umber_Tons JIMNo.of Self-Contain F _ Totals:, Il Detection/Alertin&�Devices No.of Dishwashers Space/Area HeatingKW Local 0 Municipal ❑ Other P Connection No.of Dryers Heating Appliances I{Vl Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicesonsWiring: 1 No.of Devices or Equivalent e 1 OTHER: Vv Attach additional detail ifdesired or as required by the Inspector of Wires. Z Estimated Value of Electrical Work: (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 El BOND 0 OTHER 0 (Specify:) • I cert,under the pains and penalties of perjury,that the information on this application Ls true and complete. FIRMNA c U) N5Lpt0 •1 h I' r SO[o S - ' LIC.NO.: 3; 'l� � Lleensee:',[GSM) /1I tWM) Signature jJ LIC.NO.o)i$rt`kil ' (Ifapplicable,enti'"am m.t"inthe license n berline.) I Bus.Tel.No.•� / 6S.g9�•72'� Address: " L- ' /a0 tali Int ; r O a rn 0 Alt.Tel.No *Per M.O.L.c.147,s.57-61,security wor requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. natre Owner/Agent Telephone No. I PERMIT FEE:$ O 00 I di?' 4 • • nw The Comonwealth ofMassacltetts Department oflndustrialAccidents 1 Congress Street,Suite 100. . _ Boston,MA 02114-2017 6.,;04 www.mass.gov/dia Workers'Compensation Insurance Affidavit:General Businesses.. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Business/Organization Name:E.F.WINSLOW PLUMBING&HEATING CO.,INC • ' Address:6 REARDON CIRCLE City/State/Zip:SOUTH YARMOUTH,MA 02664. Phone#:508'3947778 Are you an employer?Check the appropriate box: Business Type(required): 1.0 I am a employer with ) employees(full and/ 5. 0 Retail • or part-time).* • 2.❑ I am a sole proprietor or partnership and have no 6. Office uranf/B Sales(g Establishment employees working for me in any capacity. 7. []Office and/or Sales(incl.real estate,auto,etc.) [No workers'comp.insurance required] 8. 0 Non-profit 3.❑ We are a corporation and its officers have exercised 9. 0 Entertainment • their right of exemption per c.152,§1(4),and we have 10.0 Manufacturing no employees.[No workers'comp.insurance required?* 4.❑ We are a non-profit organization,staffed by volunteers, 11.[I Health Care with no employees.[No workers'comp.insurance req.] 12.0 Other *Any applicant that checks box 01 must also fill out the section below showing their workers'compensation policy infoimation. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. ' I am an employer that is providing workers'compensation insurance for my employees. Below Is the policy information. Insurance Company Name:ARROW MUTUAL INSURANCE COMPANY Insurer's Address:23 COMMONWEALTH AVE City/state/zip: CHESTNUT HILL,MA 02467 • Policy#or Self-ins.Lie.#1821A 01/01/2041 Attach a copy of the workers'compensation policy declaration page(showing the poI cy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. • Ido hereby cerci la tinea and enaltles o perjury that the information provided above Is true and correct Signature: 71-� Date: ) 13' I I Phone#:508.394.7778 • Official use only. Do not write In this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): • • 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Licensing Board 5.Selectmen's Office 6.Other ContactPerson: Phone#: wwwmasagov/dia l.:YgR_ TOWN OF YARMOUTH �, BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 N ... .. ,. ... •._•cam,,, „q ,�, 508-398-2231 ext. 1263 Fax 508-398-0836 ».• w K. Elliott, Inspector of Wires keltiott4I yarmouth.ma.us June 14,2018 Richard Melvin E. F.Winslow Plumbing& Heating 8 Reardon Circle South Yarmouth,MA 02664 RE: Brian McGuiness, 54 Scholl Ave,W. Yarmouth Permit Number: BLDE-18-006256 Dear Rich; The above noted location inspection failed to pass for the reason(s) listed. Article 110-26 Spaces about electrical equipment Article 358-30(A) Securing & supporting EMT Please forward the required re-inspection fee of eighty dollars ($80.00) to this office and advise when the corrections have been made and when access may be gained, to the property, for the re-inspection. If you have any questions please do not hesitate to contact me. Sincerely, Town of Yarmouth,Building Department K.Elliott, Inspector of Wires