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Home My WebLink AboutBLDE-22-000476 Commonwealth of Official Use Only i ` Massachusetts Permit No. BLDE-22-000476 if . 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:7/26/2021 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 Owner's Address N R NOMINEE TRUST, 170 MAYFLOWER TERR,SOUTH YARMOUTH, MA 026640 Is this permit in conjunction with a building permit? Yes 0 No 0 Purpose of Building (Check Appropriate Box) Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 New Service gNo.of Meters Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install generator 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 1 KVA 22 No.of Luminaires Swimming Pool Aboved. ❑ In- ❑ No.of Emergency Lighting grn 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 Initiative Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alertine 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 0 OTHER 0 I certify,under the pains and penalties operjury,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 normall required signature below,I hereby waive this requirement.I am the(check one) y q by law.But my Owner/Agent 0owner ❑ owner's agent. Signature Telephone No. PERMIT FEE:$50.00 7Qd, 14c 4 Commonwealth of Massachusetts �' �`, Official Use Only (- !« Department of.Fire Services Permit No. (� / == ? "^•Y;;i, BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.9/031 leave blank -- —� APPLICATION FOR PERMIT TO PERFORM L CTI`�l�jr All work to be performed in accordance with the Massachusetts Electrical Code �.0 uORK (.PLZISE PRINT 1NINIC OR TiPEALL INFO ( C>,527 CMR 12.00 City or Town of: RrYl�T.ION) Date: 1 I By this application the undersigned give notice or her intention to e£olthe Inspector of WTo res. Location(Street&Number) L 1 U P m the electrical work described below, Owner or Tenant Afi'_t f I v r✓t✓ "t Ce 5, YN/h20 t/ (�`Z4‘ Owner's Address Telephone No,Z?1Z(ZT Z, 5(1 Is this permit in conjunction with a building permit? Yes ❑ N0 (Check Appropriate Box) Purpose of Building W N' Utility Authorization No. Existing Service Amps • / __ • ___ 'Volts Overhead E Undgrd• New Service Amps / ❑ No.of MetersNumber of Feeders andAtnpasiLy Volts Overhead E Hndgrd `-- ❑ No,of Meters Location and Nature of Proposed Electrical`Work: W • Completion o the oflowin:table in, be waived b the Inspector'o Wires, No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans TNo.of Total No, of Lu oinaire Outlets No.of Hot Tubs ener ato-toners KVA G Generrs JfVA 0 No.of Luminaires Above Swimming Pool :r'nc7. ❑ Zn- 'o. e i rkrez geney xg z'zng No.of Receptacle Outlets .rnd. 0 Batt Units • No.of Oil Burners f I No,of Switches • RE ALARMS No,of Zones No.of Gas Burners No. of Detection and No.of Ranges Initiatin:Devices No. of Air Cond. ota No.of baste Disposers Heat Pump Tons No.of Alerting Devices Totals: Number Tons No.of Self Co . ntairzed No.of Dishwashers Detection/Alertin: Devices Space/Area Heating I y Local❑Municipal No. of Dryers 1TeatingAppliances Connection ❑Other j No.of Water KW SecNo,o'Systems:* Heaters z W No. of No,of Devices or .nivalent Si ns No, of Data No,Hydage Bathtubs Ballasts No.offlg: No. of Motors of Devices or E.nivalent • • OTHER.: Total HP Telecommunications Wiring: No.of Devices or Ea-trivalent Estimated Value of Electrical Work: Attach additions/detail U`'desired o�� Work to Start; as YegztiYed by the Inspector of Nitres. (When required by municipal policy,) INSURANCE Inspections to be requested in accordance with MECRule 10,and upon completion. COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may the licensee provides proof of liability insurance including"completed operation"coverage or undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issue unless CHECK ONE: INSURANCE g its substantial equivalent, The I certify,cruder the pains and p0 It1OND ❑ OTHER issuing office, � ❑ (Specify:) >i.RM NAME; E.F, WINSLOW PLUMBING perE&,H,at the EATING information Itor�on this ap RICHARD MELVIN p licatior�is trcte and complete. ('J applicable, enter"exempt"in the license number lure.) Signature LW,NO.:S28'(C Address; a REArmoN aIROLR SOUTH YARMOU • LIC•N0.:•2"(829A *Security System Contractor License required for this if a Bus.Tel. soe-ssq'777a OWNER'S S stemContractor No,: WAIVER: applicable,enter the license number here: N0,, I am aware that the Licensee does not have the liability insurance covers e `n required bylaw,INSURANCE y signature e below,I hereby waive this requirement. [ N Owned g normally �� Signature am the(check one . ownez' nercnt, Telephone No, E,F, Winslow inspection De X'.�`�IY.�Z�'.�,�'E: '� Department email: inspections@efwinslow.com