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Home My WebLink AboutBLDE-22-000057 41 _.- Commonwealth of Official Use Only ICE. Massachusetts Permit No. BLDE-22-000057 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:7/6/2021 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) 1 JIBSTAY RD Owner or Tenant LIFTMAN BARBARA S Telephone No. Owner's Address 31 BLITHEWOOD AVE UNIT 1206,WORCESTER, MA 01655 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: Bathroom remodel 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- ElNo.of Emergency Lighting 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 No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW 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 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 Licensee: RICH M MELVIN Signature LIC.NO.: 21829 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 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 req ' .. b 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. PERMI .E: $50.00 NM WP 7 Z L Haiti 4t'/ c) ® , w 0 3 1-11Q14-t- 2 i 0 A-L)) _ - CommoJ wealth of Massachusetts Official Use Only �Yw�! � �'= Department of Fire Services Permit No. 22� Q '7 01777. BOARD OF FIRE PREVL►vTIoN REGULATIONS Occupancy and Pee Checked ""' [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 1R.INT,XN MK OR TYPE ALL INFORMATION) Date: 6/ /Z/ City or Town of: l✓ld i44 To the Inspector of Wires: By this application the undersigned gives notice of hi or her intention to perform the electrical work described below, Location(Street&Number) R ive J f(,I Dd/- 104 7 $ Owner or Tenant BGif 1jjelTh (`(4-n'1Art/ Telephone No.5CK 6 Y Y 070 Owner sAddress 3 i )3 I:l-tn,,,,,d Ave #)TO 6 ulo f tries)-�r MA O/) Y Is this permit in conjunction with a building permit? Yes n No ofI.`'f� lChecXzAppxopxiateBox) Purpose Building ��',//•2 tl1 y Utility Authorization No. Existing Service Amps . / Volts Overhead LI Uri d rd g 1.--- No,of Meters New Service Amps / Volts Overhead U Undgrd n No,of Meters Number of Feeders and Ampa city Location and Nature of Proposed Electrical'Work: I�{ mf-li rovifil /�litido j No,of JRecessed Luminaires letion o the ollowin table in be waived b the Ins cam.o Wires, No.of C il e . Susp.(Paddle)b Com ans No.of Total Transforrners KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above t—� In- No.of Emergency Lighting nd, I I grnd. U Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS JNo,of Zones i No.of Switches • No.of Gas Burners No.of Detection and Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Co nnectio n ectio • n I .I Other I I Co No,of Dryers Heating Appliances IOW Security, 'sy�stenos:* No,of Water I No, of No, of No of Aevics or Equivalent Data Wiring; Beaters Signs Ballasts • No.of Devices or Equivalent No,Hydrornassage 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; 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 J �� 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 10 BOND ❑ OTHER S eoi I cent fy,under the pains andpenaltles o au that the information on this ap licrttiorz is true and complete. FIRM NAME; E,F, WINSLOW PLUMBINGe1• &HEATING CO,, I Licensee; IZICHARD MCI_VIN •LW,NO.;328'1 C s Signature _ (If applicable, enter "exempt"in the license number line.) Address; a REARDON CIRCLE SOUTH YARMOUTH,MA 02664 • LIC.N0,:21829A Bus.Tel.No,:uo8-as9�777e *Security System Contractor License required for this worfc;if applicable,enter the license numbeltr here:No,: tvn OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally C—' Ln required bylaw, By my signature below,I hereby waive this requirement. I am the(check one owner owner's a.ent, v Owner/Agent Signature I] Telephone No. PERMIT MIT FEE: $ 1 C.F. Winslow Inspection Department email: inspections@efwinslow,com