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Home My WebLink AboutBLDE-21-006836 Official Use Only a Commonwealth of c-.'..., Massachusetts Permit No. BLDE-21-006836 ' 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:5/24/2021 To the Inspector of Wires: City or Town of: YARMOUTH By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 110 EVERGREEN ST Owner or Tenant FALCONE RALPH A TRS Telephone No. Owner's Address FALCONE ALICE C, 110 EVERGREEN STREET, 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 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 NC condenser. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- ElNo.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS INo.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiatine Devices No.of Air Cond. 1 Total No.of Alerting Devices No.of Ranges Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alertine Devices 0 Municipal No.of Dishwashers Space/Area Heating KW LocalConnection ❑ Other: Security Systems:* No.of Dryers Heating Appliances KW No.of Devices or Equivalent NoNo.of No.of Data Wiring: He Water KW Signs Ballasts No.of Devices or Equivalent Heaters Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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: JOSEPH V SLOWEY LIC.NO.: 11186 Licensee: Joseph V Slowey Signature (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: $50.00 I Commonwealth,olf MaMachuoett6 Official Us Only '`-=`—fl Permit No. �� 3 �1- 1 Thepartment o f Sire Services =j` Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07 �:,;��, � � (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: cc , / Q i aaRI City or Town of: YCl r (Yl C)(A.T t--E 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) /{f E V e rj (e e h LS% Owner or Tenant la a(f b �a t ea n e. Telephone No. $'b p'067f2 Owner's Address Is this permit in conjunction with a building permit? Yes C No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead n Undgrd n No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ECompletion 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 i 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 Tons No.of Alerting Devices 9) Heat Pump Number Tons KW No.of Self-Contained • v No.of Waste Disposers Totals: Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other 13 No.of Dryers Heating Appliances KW Security Systems:* r`y No.of Devices or Equivalent V No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: y g No.of Devices or Equivalent 0 OTHER: —1 Attach additional detail if desired,or as required by the Inspector of Wires. 7 Estimated Value of Electrical Work: i g 0-0 (When required by municipal policy.) Work to Start: 5 . t9• 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 vi undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. `., CHECK ONE: INSURANCE [51- BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. dFIRM NAME: ci D52;Ph \J 5 tot (e C-t12tC-tu h LIC.NO.: Licensee: I&Q. 5(pt., )P Signature �� fSlnB 7- LIC.NO.:l/! d (If applicable, enter "exempt"in the ltense number line.) ?ell Bus.Tel.No.:5t�£f d80 W Address: /OO 'ir watercDur5,2_ Ptac..II V i yi77Dal►, 171Q. c.)Q1,30O Alt.Tel.No.: *Per M.G.L.c. 147,s. 57-61,security work regthres Department of Public Safety"S"License: Lic.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)❑owner ❑owner's agent. Owner/Agent PERMIT FEE: $ r Signature Telephone No. __a