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Home My WebLink AboutE-19-6765 �, N Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-006765 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:5/30/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives no ice o is or er in en ion o pe orm e e ec-r— Location(Street&Number) 22 CAPT BEARSE RD Owner or Tenant e ep one o. Owner's Address 22 CAPT BEARSE 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 ❑ 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: Re-model/Re-wire house. 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 0 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 0 OTHER ❑ (Specify:) 32/_-.�fl S I certify,under the pains and penalties of perjury,that the information on this application is true and complete. 5C! 7 tGI Caw FIRM NAME: Joseph V Slowey Licensee: Joseph V Slowey Signature LIC.NO.: 11186 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 168 WATERCOURSE PL, PLYMOUTH MA 023603629 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 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 (r-b-i-et& el71/ 1 ` (spt tea/dew._ zca/s/Aemb h/'`lli 1 I //. Commo sa yyyy�/of///assaclsusafts .. Official Use my .-_ - y _iris � V =-ev_ �aParlixarf ol �crvices Permit No. .......(CI r Occupancy and Fee Checked r-:.S,S. BOARD OF FIRE PREVENTION REGULATIONS {Rev. 1/07] APPLICATION (leave blank) LICATION FOR-PERMIT TO PERFORM All work to be performed in accordance with the Massachusetts ELECTRICAL WORK (MEC),527 CMR 12.00 MA (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 5 //?mot/%t City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersigned gives notice of his or her intention to perform the electrical work described below. _,location (Street&Number) C ' ...— .,.�. Owner or Tenant ( �/ ��{'/-Y�-�- �d�A. — �_ Y i1`Y, Telephone No. i/n. gjZ L' _ Owner's Addresss)77 E,;r , Isla-,.,( 1.6,. c- , `' �k� Is this permit in conjunction with a building permit? Yes t `No ❑ (Check Appropriate Box) Purpose of Building � Si� �� C9 Utility Authorization No. ?' Existing Service I 00 Amps I2 p /,� `''()Volts Overhead ❑ Undgrd El No.of Meters i I ., New Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters Number of Feeders and Ampacity -- - Location and Nature of Proposed Electrical Work: ''ram..►+'1 b ck..fC'A — � W r_r-z, 6 b l'vu2., Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires INo.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- D No.of Lmergency Lighting arnd. 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. Tan No.of Alerting Devices No.of Waste Disposers Heat Pump]Number Tons H KW No.of Self-Contained ( Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal oth Connection ❑ � No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No. of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP (Telecommunications Wiring: OTHER: 1 No.of Devices or Equivalent i Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work 6 a C)0 (When required by municipal policy.) 4' Work to Start: 5" Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE GE: Unless w hed by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability j surance including"completed operation"coverage or its substantial equivalent, The G undersigned certifies that such cove ge is in force, and has exhibited proof of same to the permit issuing office. . i CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of erjury,that the information on this application is true and complete. FIRM NAME: 0—i)5-e pl. v S _ c] Licensee: �� '`� LIC.NO.: �! jr;� SIoLve ' USignature� (If applicable, enter "ere t"in thy' I J LIC.N O.: , P tcense nu Aber line.) • . Address. c ^,ir t c rS� rf� Bus.Tel.No..�C) _�Z� t Per M.G.L. c. 147,s.57-61,security worrequires D 1, rah b 2"�iN 0 Alt.Tel.No.c. : x La, �nt of Public Safety"S"License: OWNERS 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 o Owner/Agent ❑owner's a eat Signature 7S Telephone No. PERMIT FEE: $