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Home My WebLink AboutBLDE-22-000477 Commonwealth of Official Use Only 11:. Massachusetts Permit No. BLDE-22-000477 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07j 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:7/26/2021 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) 170 MAYFLOWER TERR Owner or Tenant RUDZINSKI NEIL TR Telephone No. Owner's Address N R NOMINEE TRUST, 170 MAYFLOWER TERR,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 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement service. Completion ofthe 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 g boved. ❑ grnd. ❑ No.of Emergency Lighting rn 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 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 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No No.of Devices or Equivalent HeatersWater KW No.of No.of Ballasts Data Wiring: Signs 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 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 - - Commonwealth of Massachusetts Official(Ise Only - r 4�J`i Gin.=Y t ` All= Department of Fire Services Permit No. ZZ 477 a i`(— Occupancy and Fee Checked ?,`, ,,�r� BOARD OF FIRE PREVENTION REGULATIONS (Rev.9/o5� (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 YRINT_AT INK OR TYPE ALL INFORt1 ITION) Date: 11/5/ Z 1 City or Town of: `r 031001-tx 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) V 1 0 P ct,y f I o v✓tr TPff r•e- 5r Yarn-co V tl► a 26'07„ Owner or Tenant Ives` Ik,t)Zt05k1 Owner's Address Telephone No.-1/4 t 2.151 5gW1t Is this permit in conjunction with a building permit? Yes E' No y Purpose ofS�uilding b W(A l� I� (ChecXc.�ppropriafieBox) 1 Utility Authorization No. Existing Service Amps • / Volts Overhead r� wl '(in dgrd I I No.of Meters New Service Amps / 'Volts Overhead l)el Ilndgrd Number of Feeders and Arrspacity No,of Meters Location and Nature of Proposed Electrical'Work: Zoe)4 pH gena.21 eie �'(Ji4r.�'rn,cnJ'f'" Completion of the foilowin,tgble may be waived by the Inspector of Wires, No.of Recessed Luminaires No.of Ceil.•-Susp.(addle)pans No.of Total Transformers KVA No.of Lurninaire Outlets No. of Hot Tubs • Genex•ator•s KVA. No.of Luminaires Swimming Pool Above In' No.of nrerger�cy Lightinggr ncl. L grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRM ALARMS INo.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 Heatl'ump Number Tons IXV No. ofSelf Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local Municipal No.of Dryers Coxrxreetion � Other xY XleatingAppliances KW Security'Svstenrs:* No.of Water` ICJ No, of No, of No. fDe ices or Equivalent Signs Ballasts Data Wiring: Heaters Signs • No.Ilydr orxrassage BathtubsNo.of Devices or Equivalent No. of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires, (When required by municipal policy,) Work to Start; Inspections to be requested in accordance with lV1EC 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 o Pliability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is hi force, and has exhibited proof of same to the permit issuing office, CHECK.ONE: INSURANCE 2 BOND El CD I certify,under the pains and penalties o OTTER 0 (Specify:) p f perjury, that the information on this application is lrtte and complete. MAIN/NAME; E.F, WINSLOW PLUMBING & HEATING CO„ Licensee: RICHARD MELVIN ETC,NO.;328'10 Signature LTC.NO,:2'(829A Licensee:applicable, eater "exempt"in the license number line,) Address; e REAROoM CIRCLE SOUTH YARMOUTHI,MA 02664 Bus.Tel.No,:50e-394�777e *Security System Contractor License required For this work;if applicable, enter the license ntttnAl .Teel. .No,; 60 v` OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally 0' required by law. By my signature below,I hereby waive this requirement. I am the check one o Owner/Agent �y l`i� Signature ( weer' owner's errt, �� Telephone No, PERllIT. .g',E: , E.F. Winslow Inspection Department email: inspections a efwinslow.Cor