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Home My WebLink AboutBLDE-22-000706 RM 212 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-000706 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:8/9/2021 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) 237 NORTH MAIN ST Owner or Tenant DAVENPORT DEWITT TR Telephone No. Owner's Address DAVENPORT REALTY TRUST, 20 NORTH MAIN ST, SOUTH YARMOUTH, MA 02664-3150 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 ❑ Undgrd 0 No.of Meters New Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity , -f s Location and Nature of Proposed Electrical Work: Replacement A/'- ,,, 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 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 Gas Burners No.of Detection and No.of Switches Initiating Devices No.of Air Cond. 1 Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Space/Area HeatingKW Local ❑ Municipal 0 Other: No.of Dishwashers P Connection HeatingAppliances No.of Dryers PP 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 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. required bymunicipal policy.) Estimated Value of Electrical Work: (Whenq P P y' 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 LIC.NO.: 21829 Licensee: RICH M MELVIN Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:8 REARDON CIRCLE, SOUTH YARMOUTH MA 02664 *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 I PERMIT FEE: $50.00 I Signature Telephone No. W‘ cl_ 1 (gAltrl _ Commonwealth of Ma6sachtxsetts Official Use Only %-0- ,c i Permit No. Z .- d 7 Q 4:::, ow Department of Fire Services e, « BOARD OF FIRE PREVENTION REGULATIONS [Rev.9 pg�y and Pee Checked ?� (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 INFORIVIATION) Date: ? /50 /Z City or Town of: %foridU it 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 86,Nurnber) 213j 7 /l'o(/4i PHidt 57nt, �yjjv�L Ya//Ld�t'1a OzePi Ci ii1 4 Z- I a Owner or Tenant /A//pVOd dfi. Pk e.- Telephone No.50(b ji%$0 06 Owner's Address 5c# Z • Is this permit in conjunction with a building permit? Yes NoClrecic Appropriate Box) Purpose of Building Aq itln j Utility Authorization No. • Existing Service Anips . / Volts Overhead Undgrd No.of Meters • New Service Amps / Volts Overhead Undgrd No.of Meters Number of Feeders and Axnpacity Location and Nature of Proposed Electrical Work: ,, \ ,C j A5j;k-ol((q 4 OM . Completion of the followin•table may be waived by the Inspector of Wires, • No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans of Total Transformers JE�'V'.A.. No.of Luminaire Outlets No.of Hot Tubs • Generators I.VA No.of Luminaires SwimmingPool Above --• In- .No.of Emergency Lighting grnd. grad. I Battery Units • No.of Receptacle Outlets No.of Oil Burners f FIRE ALARMS No.of Zones No.of Switches • No.of Gas Barriers No.of Detection and Initiating Devices . No.of Ranges No.of Air Cond, Tansl No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating K1•'V Local' I Municipal Other Connection • No.of Dryers Beating.A.ppliances KW Security's steps:* No.of Devices or Pquivalent No.of Water I 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 OTHEX2.: 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 FA BOND U OTHER ❑ (Specify:) , I certify,cruder the pains andpenatties of pedury, that the information on this ap licatiou is true and camplete. S+X IV.(NA1v.(E; C.F,WINSLOW PLUMBING 8: HEATING CO„ I _ .MC,NO..328'I C Licensee; RICHARD MELVIN Signature • LIC.NO.:21829A Uf applicable, enter "exempt"in the license number line) Bus.Tel.No,:sos-ss4 777a Address; a Ru4RtiotI CIRCLE SOUTH YARMOU?il,MA 02664 Alt.Tel.No,; M ,M *Security System Contractor License required for this work;if applicable,enter the license number here: L p OSrVNER'S INSURANCE WAIVER: I am a.ware 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 ono) owner owner J❑owner's agent, --..... r, Owner/Agent PEWIT FEE: $ I L Signature Telephone No, l am' LA E.F. Winslow Inspection Department email : inspections a efwinslow.com