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HomeMy WebLinkAboutBLDE-22-001916 os Commonwealth of Official Use Only - A I. i �' Massachusetts Permit No. BLDE-22-001916 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:10/5/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intentign to perform the electrical work described below. Location(Street&Number) 481 BUCK ISLAND Rik .i € Owner or Tenant Beth Von Staats Owner's Address 481 BUCK ISLAND RD UNIT 8A,WEST YARMOUTH, MA 02673 Telephone No. 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 ❑ Undgrd 0 gNo.of Meters New Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement HVAC. 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 Above ❑ Irnd. ❑ No.of Emergency Lighting No.of Luminaires Swimming Pool g Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiatine 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 Heating KW Municipal Local ❑ Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent KW No.of No.of Ballasts Data Wiring: Heaters Si2ns 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 ❑ (Specify:) I certify,under theandpenalties o pains 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 LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 21829 Address:8 REARDON CIRCLE, SOUTH YARMOUTH MA 02664 Bus.lt. Tel.No.::: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel. 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)) CI owner ❑ owner's agent. Owner/Agent Signature Telephone No. 'PERMIT FEE:$50.00 I c ,1 17 t - Commonwealth of Massachusetts Official Use Only Permit No. ZZ- \ I �P Department of Fire Services -'1f Occupancy and Fee Checked -- BOARD OF FIRE PREVENTION REGULATIONS �'`—',n� [Rev.9/05] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9/29/21 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number)481 BUCK ISLAND ROAD UNIT#8-A 0 Owner or Tenant VON STAATS,BETH Telephone No. 5087377413 Owner's Address SAME Is this permit in conjunction with a building permit? Yes ❑ No ❑✓ (Check Appropriate Box) Purpose of Building DWELLING Utility Authorization No. j Existing Service Amps / Volts Overhead � New Service ❑ Undgrd❑ No.of Meters Amps / Volts Overhead❑ Undgrd ❑ No.of Meters 7 Number of Feeders and Ampacity .. Location and Nature of Proposed Electrical Work: GAS FURNACE AND COIL REPLACEMENT ID Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total COansformers KVA l� ' No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- No.of Emergency Lighting grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones C.-•1 No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: 1 Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal ❑Connection ❑Other No.of Dryers Heating Appliances Kam, Security$ystems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts 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 iaapector 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 ❑ OTHER 0 eci S I certify, f perIury,that the,under the pains and penalties o , (Specify:) information on this ap lication is true and complete. FIRM NAME: E.F. WINSLOW PLUMBING & HEATING CO., I Licensee: RICHARD MELVIN LIC.NO.:3281 C Signature LIC.NO.:21829A (/fapp/icable,enter "exempt"in the license number line.) Address: 8 REARDON CIRCLE SOUTH YARMOUTH,MA 02664 Bus.Tel.No.:508-394-7778 *Security System Contractor License required for this work;if applicable,enter the license num elr here: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)Downer ri owner's agent. Owner/Agent Signature Telephone No. 1 p I PERMIT FEE: $ E.F. 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