HomeMy WebLinkAboutBLDE-22-002195 \'kk Commonwealth of Official Use Only
' :'‘i Massachusetts Permit No. BLDE-22-002195
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 Codc (MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:10/18/2021
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) 135 CAPT BACON RD
Owner or Tenant JOHNSON VILMA M Telephone No.
Owner's Address 135 CAPTAIN BACON RD, SOUTH YARMOUTH, MA 02664-2849
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: Upgrade service&install generator.
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 1 KVA 13
No.of Luminaires Swimming Pool Above ❑ In- 1:1No.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 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: 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
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Commonwealth of Massachusetts Official Use Only
Permit No.
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�I- Department of Fire Services
"),--t1L--- -1 Occupancy and Fee Checked
?.�t , BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (leave blank)
rn0) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
i4 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 10/10/21
...- City or Town of: YARMOUTH To the Inspector of Wires:
Lo By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number)135 CAPTAIN BACON ROAD
Owner or Tenant VILMA JOHNSON Telephone No. 5087606761
rOwner's Address SAME
(V) Is this permit in conjunction with a building permit? Yes El No ❑✓ (Check Appropriate Box)
Purpose of Building RESIDENTIAL Utility Authorization No.
Existing Service Amps / Volts Overhead El Undgrd El No.of Meters
r\ New Service Amps / Volts Overhead El Undgrd❑ No.of Meters
.) Number of Feeders and Ampacity
VJ Location and Nature of Proposed Electrical Work: 100 AMP SERVICE,& 13 KW GENERATOR
Completion of the following table may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tof
Traa onKVAsformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators 13 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
Detectionand
Initiating
Devices
No.of Ranges No.of Air Cond. TORI 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 S stems:*
No.of Devices or Equivalent
No.of WaterKW 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: 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 ® BOND 0 OTHER ❑ (Specify:) .
I certify,under the pains and penalties of perjury,that the information on this ap lication is true and complete.
FIRM NAME: E.F. WINSLOW PLUMBING &HEATING CO. LIC.NO.:3281C
Licensee: RICHARD MELVIN Signature LIC.NO.:21829A
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:508-394-7778
Address: 8 REARDON CIRCLE SOUTH YARMOUTH,MA 02664 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 by law. By my signature below,I hereby waive this requirement. I am the(check one)El owner ❑owner's agent.
Owner/Agent PERMIT FEE: $
Signature Telephone No.
• E.F. Winslow Inspection Department email : inspections@efwinslow.com