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Home My WebLink AboutBLDE-22-001280 I OMCommonwealth of Official Use Only Massachusetts Permit No. BLDE-22-001280 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:9/6/2021 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) 10 JOHN HALLS CARTPATH VI Owner or Tenant Sandra Brooks Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (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 AIR CONDITIONING. 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. 1 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 Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Euuivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens 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: E F WINSLOW PLUMBING HEATING CO INC Licensee: RICH M MELVIN Signature LIC.NO.: 21829 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:8 REARDON CIRCLE,SOUTH YARMOUTH MA 02664 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 • /l1%S/�21,� 4 Ziu. e Z • S f 9 L (UV Z .r Co,C ' ri on wealth of illa.ssachusetts Official Use Only rer i ce t Permit No. —I‘^z 0 ^I nI= Department of Ffre Services � « BOARD OF FIRE PREVENTION REGULATIONS lxev g osay and(l eyeaveeeblank)Cheolced "'""" APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MBC),527 CMR 12.00 (PLEASE_PRINT EN JJ K OR TYPE ALLDa'ORMATIO.N) Date: i 1 Z 5,Z I City or Tom.of: Wiryn pi/i'h/"0- To the Inspector of Wires: By this application the undersigned gives notice of his or er Intention to perform the eleotrioal work described below, Location(Street&Number) 1 t) I0l yl /c°l ij Qv-II-writ,y 1 4in'o✓ +Ay°c4' CZ 6j 7 5 Owner or'Tenant SrveLdirk e.t.a()e.t.a()/rs J t Telephone No.111 1 . (-+N 7 Z Q Owner's Address $Ct ne. Is this permit in conjunction wzth a building permit? Yes n No f (Check Appropriate Box) Purpose of Building nth Utility Authorization • BxistingSer•viee Amps J . / Volts Overhead n I(7radgrd n No,of Meters New Service Amps / Volts Overhead L ll'ndgrd❑ No,of Meters Number of Feeders and Ampa city Location and Nature of Proposed Electrical'Woi.k: '�c C ( ,i. k(�(044 . Completion of the followinpigble may be waived by the Inspector of Wires. • No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of 'Dotal Transformers ICU. No.of Luminaire Outlets No.of Hot Tubs • Generators KVA No.of Luminaires Swimming Pool Above In- No.of li;rnergency Lightingrid, n grnd, II Battery Units No.of Receptacle Outlets No.of Oil Burners FIR.E ALARlVIS No,of Zones No,of Switches No,of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. xonsl No.of Alerting D evices No,oWasteDisposers Heat Pump Number. Tons Zip No.ofSelf Contained Totals: ""'' "" Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal n Connection Other No.of Dryers Heating Appliances W SecuritySryystexns: ' ] No,of Devices or Equivalent No,of Water No. of No, of g: Healers ICW Si ns Ballasts Data Wirin �/l g No.ofDevzces orBejuivaZent No.Hydrornassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No,of D eviees or Equivalent ox>F ml Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required bymunloipal policy,) Work to Start; Inspections to be requested in accordance with MEC Rule 10,and upon completion. Vc INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless o the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The IVN undersigned certifies that such coverage is In force, and has exhibited proof of same to the permit issuing office. ,— (J CHECK ONE: INSURANCE 21 BOND ❑ OTHER ❑ (Specify:) I certify,wiirler the pains and penalties ofperfzuiy,that the information on this'ap lication is trite and complete. pl tYfNAME; E.F.WINSL OW PLUMBING l;< HEATING CO„ I LIC,NO.,328'IC S Licensee; RICHARD MELVIN Signature • LTC.NO,:21 829A (If applicable,enter"exempt"in the license number line) Bus,Tel.No,:5o6-3n l-777s Address; a REARDON CIRCLE SOUTH YARMOUTH,MA ozee4 Alt.Tel.No,; *Security System Contractor License required for this work;if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required bylaw. By my signature below,I hereby waive this requirement. I am the(cheek one)^❑owner n owner's agent, Owner/Agent . Signature Telephone No, I.PERIY,IIT FEB: $ I ' E.F. Winslow Inspection Department email : inspections c@efwinslow.com V • so- The Commonwealth of Massachusetts wza�� Department of XndustrialAccidents 1-- Lafayette Office of.Investigations • i w _ City Center ice.= C,: r� =�� 0 2 Avenue de Lafayette,,Boston,llXA 02111-•1750 ,'„5 www.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Legibly Business/Organization Name: E.F.WINSLOW PLUMBING &HEATING CO, INC. Address:8 REARD O N CIRCLE City/State/Zip:SOUTH YARMOUTH, MA 02664 Phone#:508-394-7778 Are you an employer? Check the appropriate box: Business Type(required): 1.1101 I am a employer with 90 employees (full and/ 5• []Retail or part-time).* 6. ❑Restaurant/Bar/Eating Establishment • 2.I 1 I arm a sole proprietor or partnership and have no 7. 9 Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity. [No workers' comp. insurance required] 8 ❑Non-profit 3.1 I We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152, §1(4),and we have 10.0 Manufacturing no employees. [No workers' comp.insurance requiredr* 11.0 Health Care 4. We are a non-profit organization,staffed by volunteers, - with no employees. [No workers' comp.insurance req.] 12.[] Other . • *Any applicantthat checks box#1 must also fill out the section below showing their workers'compensation policy information. **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. X 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: City/State/Zip: Policy#or Self ins.Lie.#1964A Expiration Date:01/01/2022 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under§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. X do hereby ceerr-y}r-htn eej the/mains and penalties ofperjury that the informatiorrprovided above is true and correct. 01/02/2021 Signature: 9 / �^`—" Date: . 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(check one): 1.I-1Board of Health 2.0 Building Department 311(City/Town Clerk 4.[DLicensing Board 5. Selectmen's Office 6.[(Other Contact Person: Phone#: www.Inass.gov/dia o� 'YAR,� TOWN OF YARMOUTH ' - O BUILDING DEPARTMENT o . -y 1146 Route 28, South Yarmouth, MA 02664 MATTAGM Esc��_JJJ 508-398-2231 ext. 1263 Fax 508-398-0836 �nA.OR.IO S' �y K. Elliott, Inspector of Wires kelliottnvarmouth.ma.us October 14, 2021 E. F. Winslow Plumbing& Heating Rich Melvin 8 Reardon Circle South Yarmouth, MA 02664 RE: Permit Number BLDE-22-001280 Dear Mr. Melvin; The above noted location inspection failed to pass for the reason(s) listed below. • A230.63 —Receptacle required within 25 feet of new AC condensing unit. 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 AJ Pulley, Assistant Inspector of Wires C: Ken Elliott