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Home My WebLink AboutBLDE-22-000481 Commonwealth of Official Use Only �: Massachusetts Permit No. BLDE-22-000481 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:7/26/2021 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) 19 WHIFFLETREE RD Owner or Tenant STAMBONI VINCENT J Owner's Address 6670 AMPERE AVE, NORTH HOLLYWOOD, CA 91606 Telephone No. Is this permit in conjunction with a building permit? Yes 0 No 0 Purpose of Building (Check Appropriate Box) Utility Authorization No. Existing Service Amps Volts Overhead 0 New Service Undgrd 0 No.of Meters Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Air conditioning system. 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 No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Area e ❑ nr ❑ No.of Emergency Lighting No.of Receptacle Outlets Battery Units p No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiative Devices No.of Ranges No.of Air Cond. 1 Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area HeatingKW Local ❑ Municipal 0 Other: No.of Dryers H Connection Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No. of No.of Ballasts Data Wiring: Sis No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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 I certify,under the pains and penalties o (Specify:) fperjury,that the information on this application is true and complete. FIRM NAME: E F WINSLOW PLUMBING HEATING CO INC Licensee: RICH M MELVIN Signature Tel. NO.: 21829 (If applicable,enter"exempt"in the license number line.) Address:8 REARDON CIRCLE, SOUTH YARMOUTH MA 02664 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 Commonwealth of t Massachusetts III_, °1=— Official Use Only _, ttll= = Department of FireServicesPermit No. � ?"^:,, t,VIVI BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked APPLICATION FOR PERMIT �O PERFORM(Rev.9/OS1 (leave blank �— I..1 All work to be performed in accordance-withco the Massachusetts ccal Code .0 WORK " �� (PL.1J'.45.1,'.P.RINT.I�I'INXC OR T.� ,Z;ALL INFO ��)�527 CMR 12.00 City or Towxr of: RMATION) Date:_ 7 % J tees notice To the Inspector of T'Yires: By this application the undersigned gives notice of his or her inten 'onto perform the electrical worlc described below, Location(Street&Number) (I, elret. / ✓4/. Uz(23 Owner or Tenant IV IA Ai- Si-kk ,al Owner's Address Telephone No, Xs this permit hi conjunction with a buildin Purpose ofBuilding I g permit? des ❑ (Check Appropriate Box) Existing Service Utilityty Authorization No. ---- Amps / 'Volts New Service Overhead C UiadgXd E No,of Meters`----- Amps / 'Volts Overhead E Unrd d Number of Feeders andAmpacity g ❑ No,of Meters Location and Nature of Proposed Electrical'Work: Com.letion o the ollowin:table m, be waived b the Xns.ecto"o Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Pans No. of Total No.of Luminaire Outlets Transformers KVA No. of Hot Tubs Generators XVA No.of Luminaires Swinxznin Pool : ncl. In- `o.o g :ma. C :rnd. ❑ nxergency tg t'rng No.of Receptacle Outlets Batte units No.of Oil Burners FIRE ALARMS and No.of Switches . No.of Gas Burners No. of Detection vice of Zones No.of Ranges xnitiafin: Devices No,of Air Cond. ota - No.of Waste Disposers Heat PumpTons No.of Alerting D evices N....r..,Tons No, f Sel✓Contained No.of Dishwashers Totals: _MI Devices Space/Area Beating KW Local Municipal No.of Dryers Beating Appliances Connection ❑Other I No.of Water KW Sec o,5 stems:* Heaters IOW No. of No.of Devices or .❑ivalent Sibs No' of Data ofD Ballasts g: No.Bydi'onrassage Bathtubs No.of Devices or g.uivalent • No. of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices OrE..niva uivalent Attach additional detail(fdesh•ed or as YevFiYed by the Inspector of Wires. Estimated Value of Electrical Work:Worlc to Start; (When required by municipal policy,) INSURANCE COVERAGE: Inspections to be requested in accordance with MEC Rule 10,and upon completion. Unless waived by the ov,,ner,,no permit for the performance of electrical work mayissue the licensee provides proof of liability insurance including"completed operation"coverage or ifs substantial undersigned certifies that such coverage is In force, and has exhibited proof of same to the permit issuing unless CHECK ONE: INS ntial equivalent. The I EB INSURANCE 0 BOND ❑ OTHER ❑ (S eoi office, � )•�. J'y,cinder the pains and' e�talties o p �`�) �, FIRM NAME: E.F. WINSLOW PLUMBINGt&�H,EATINGat the fCO1 Pion on this op Jicatior;is hue and complete. t Licensee: RiCl-IARD MEL.VIN `"' Signature •LXC,NO.;328•IC �LJ applicable, enter"exempt"in the license number line.) � `• Address; s REAROON CIRCLE SOUTH YARMOU LXC'NO•:2(829A *Security System Contractor License required for this work;if applicable enter the license nt>tnBut.Tel.No•;sos ss9.777a -------- OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability num664. Altber Tel.j co; required by law. By my signature below,I minsurance Owner/Agent hereby waive this requirement. I am the(check one coverage normally Signatureowner owner's a ent, Telephone No, E.F. Winslow Inspection Department email: inspections efw' xT @ mslow.com