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Home My WebLink AboutBLDE-22-000427 Official Use Only d Commonwealth of or vPermit No. BLDE-22-000427 . , Massachusetts �' 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:7/22/2021 City or Town of: YARMOUTH To the Inspector of Wire By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 52 HOMERS DOCK RD Owner or Tenant DUFFILL GAIL A TR Telephone No. Owner's Address THE GAIL A DUFFILL REV TRUST, 52 HOMERS DOCK RD,YARMOUTH PORT, MA 02675 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 furnace. 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- ❑ No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Detection and No.of Switches No.of Gas Burners 1 Initiating Devices No.of Air Cond. 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/Alerting Devices Local ❑ Municipal 0 Other: No.of Dishwashers Space/Area Heating KW Connection Security Systems:* No.of Dryers Heating Appliances KW 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. 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: 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 Address:8 REARDON CIRCLE,SOUTH YARMOUTH MA 02664 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 my 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 /it (74 Kg _ = Commonwealth of Massachusetts Official Use only ►nn�`° t Permit No, _..Z`�--co 4 Z7 41 ...„ Department of Fire Services •...-- BOARD OF FIRE PREVENTION REGULATIONS (Rev.9/05jy and(l a eave ee Chblank)ecked ''"�" 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: 7 120 It I City or Town of: YlGtiviOJ 3-(n 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) S I I4 r e!5 bock Q d 1 �i c)-ti14oi `7 5j 07 C " Owner or Tenant G�1 ' �, ,�Fr i� l Telephone No.502 7 Z 5 7 j Owner's Address Set 01?- Is this permit in conjunction with a building permit? Yes I I No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps . / Volts Overhead I I Tindgrd f I No.of Meters New Service Amps / Volts Overhead n Undgrd 1 1 No.of Meters Number of Feeders and Amp city / Location and Nature of Proposed Electrical Work: fvtn At.e_ tRS�I f/ON . Completion of the followinglable may be waived by the Inspector of Wiles. VAra rn No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Total TN of xansforers I{.K'P.A. No.of Luminaire Outlets No.of Hot Tubs • Generators KVA No.of Luminaires Swimming Pool Above In- No.olz�Emergencyi Units Lighting grnd, grnd. I I Battery 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. Tortsl No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.ofSelf-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating K �, W Local Co nicipil 1 I Other � I Connection No.of Dryers Heating Appliances l Security'spstems:* No,of Devices or Equivalent No.of Water No, of No, of KWData Wiring: Beaters Signs Ballasts No.of Devices or Equivalent • No,Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: 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) U N 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 ifs 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 2 BOND ❑ OTHER [] (Specify:) I certify,under the pains and penalties ofperjzty, that the information on this ap lication.is trite and complete. Fl.RIVMNA.IVIE: E,F,WINSLOW PLUMBING & HEATING CO , I (Ni LIC,N0.:328'I C r� Licensee: RICHARD MELVIN Signature LIC,N0lete. 9A (If applicable, enter "exempt"in the license number line.) Bps.Tel.No,:5oe-as4 777a Address; a REARDON CIRCLE SOUTH YARMOUTH,MA 02e64 Alt.Tel.No,; IJ N *Security System Contractor License required for this work;if applicable,enter the license number here: 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)D owner owner's agent, Owner/Agent Signature Telephone No, PERMIT FEE.' $ • ' E.F. Winslow inspection Department email : inspections@efwinslow.com