HomeMy WebLinkAboutBLDE-22-001602 RM 273 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-22-001602
es:;
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.I/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:9/21/2021
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 ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Replacement air handler&condense
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
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 I No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. 1 Total No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal
Connection 0 Other:
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of Devices or Equivalent
Heaters KW No.of No.of Ballasts Data Wiring:
Signs 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 ❑ OTHER 0
I certify,under the pains and penalties o (Specify:)
f 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 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/Agent ) CI owner 0 owner's agent.
Signature Telephone No.
gAt
� PERMIT FEE:$80.00
1
Commonwealth of Massachusetts Official Use Only
_mot Department of Fire Services Permit No. t22-(
�� REGULATIONS [Rev.9/05j
BOARD OF FIRE PREVENTION Occupancy and Fee Checked
-,.....at (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
'R 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: 9/16/21
City or Town of: YARMOUTH To the Inspector ires:
By this application the undersigned gives notice of his or her intention to perform the electrical�kdescribed below.
Location(Street&Number)237 NORTH MAIN STREET=APT#273
Owner or Tenant THIRWOOD
Owner's Address SAME Telephone No. 5083988006
. Is this permit in conjunction with a building permit? Yes El No 0 (Check Appropriate Box)
!� Purpose of Building COMMERCIAL
Utility Authorization No.
Existing Service Amps / Volts Overhead
❑ Undgrd❑ No.of Meters
NO
New Service Amps / Volts Overhead
0 Undgrd❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: AIR HANDLER&CONDENSER REPLACEMENT
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 Above In- No.of Emergency Lighting
grnd. ❑ grnd. ❑ B 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
No.of Ranges Initiating Devices
No.of Air Cond. Total
Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number I nt
Tons I KW No.of Self-Coained
Totals: r Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local Municipal
No.of Dryers i ❑Connection ❑Other
Heating Appliances Kam, Security Systems:*
No.of Water KW No.of No.of No.of Devices or Equivalent
Heaters Si ns Ballasts Data Wiring:
No.Hydromassage
Bathtubs No.of Devices or E uivalent
g No.of Motors Total HP a ecommunications Wiring:
OTHER: No.of Devices or Equivalent
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Worlc:
(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
I certi under thepains andpenalties operjury,that the information on this ap lication is true and complete. •
fY, f
FIRM NAME: E.F. WINSLOW PLUMBING & HEATING CO., I
Licensee: RICHARD MELVIN LIC.NO.:3281 C
Signature LIC.NO.:21829A
(lfapplicable,enter "exempt"in the license number line)
Address: 8 REARDON CIRCLE SOUTH YARMOUTH,MA 02664 Bus.Tel,No.:508-394-7778
Alt.Tel.*Security System Contractor License required for this work;if applicable,enter the license number 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 El owner's agent.
Owner/Agent
Signature Telephone No. I p PERMIT FEE: $
E.F. Winslow Inspection Department email : inspections@efwinslow.corn