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Home My WebLink AboutBLDE-21-007190 or 6� Commonwealth of Official Use Only L Massachusetts Permit No. BLDE-21-007190 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:6/10/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 20 MONROE LN Owner or Tenant STETKIS JON E TR Telephone No. Owner's Address THE D J C RLTY TRUST, 113 NOTTINGHAM DR,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 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 No.of Zones No.of Switches No.of Gas Burners 1 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 ofperjury,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 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 us_ ro('7ilr -kg— • Commonwealth of Massachusetts Official Use Onlynl 1,—_*,- t 2 _ 1 1(10 �,=v�i_ Permit No. ,0_. Department of Fire Services :` Occupancy and Fee Checked e -i=�- BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05j ?y�' (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(NIEC),527 CMR 12.00 • (PLEASE PRINT IN1NK OR TY E ALL WORMATION) Date: C ( Z I City or Town of: ctf/� l� To tie Inspector of Wires: ' to erform the electrical work described below, By this application the undersigned gives notice of his or her mten',, qn / Location(Street&Number) ZO 111A001U e- j vz?i W� S YptirwoiH'i 0Z6 SS Owner or Tenant (1;1 54--C,f- i 5 Telephone No. G 8 3 SC ?0 Owner's Address .1\' ND 141 4w 1 I)( g /MN H'ift 0 fr 01'6 S Is this permit in conjunction with a uilding permit? Yes I I No ( Check Appropriate Box) Purpose of Building bvni6k'i1 Utility Authorization No. Existing Service Amps '• / Volts Overhead n Undgrd I I No.of Meters New Service Amps / Volts Overhead n Undgrd No,of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: vl�t�l J 25' Jl� /r d`II 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 K.V.A. No,of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires swimming Pool Above In- No.of Emergency Lighting g grnd. n grnd. El Battery Units No.of Receptacle Outlets No.of Oil Burners (FIRE ALARMS No.of Zones and No.of Switches • No.of Gas Burners No,IfDete Initiating Devices Na. o of Ranges No.of Air Cond. T oonsl No.of Alerting Devices Disposers No.of Waste Ilzs Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Locall I Connection pl Other • No.of Dryers Heating Appliances KW Sec ,o'Sypsteins:* No r Y No,of Devices or Equivalent No.of Water KW No.of No, of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent H d• No. romassage Bathtubs No. of Motors Total HP Teleco o fDe cations Wiring. y No.of Devices or Equivalent OTHER: f 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 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 FA BOND ❑ OTHER ❑ (Specify:) • — I certify,under t/tepains andpenalties ofperjuty,that the information on this ap iication is true and complete. N (FIRM NAME; ER,WINSLOW PLUMBING& HEATING CO., I .Lie,NO.;328'10 Licensee; RICiARD MELVIN Signature <___,• • LIC.NO.:2`I829A ' (If applicable, enter "exempt"in the license number line) Bps.Tel.No,:5oe-394.777e 1 Address; e REARDON CIRCLE SOUTH YARMOUTH,MA 026e4 Alt.Tel.No„ N *Security System Contractor License required for this work; if applicable,enter the license number here: i 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) _owner owner's agent, Owner/Agent PERMIT FEE: Signature Telephone No, E.F. Winslow Inspection Department email : inspections@efwinslow.com