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HomeMy WebLinkAboutBLDE-22-003104 of Commonwealth of Official Use Only tr� q ti) Massachusetts Permit No. BLDE-22-003104 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:11/30/2021 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) 18 DAISY LN Owner or Tenant BROUTHERS ROBERT R JR Telephone No. Owner's Address BROUTHERS BRIAN, 18 DAISY LN, 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 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: 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 20 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 No.of Detection and Initiatine 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/Alertine 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 Ballasts Data Wiring: Heaters ,Siens 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. "�"� , p PERMI� i^ —(2451•Itt4 k)CONOV.7 3 I(1Wrf: (4 (IIP9- c - 9M 12,1/ N- - Commonwealth of Massachusetts Official Use Only l' - at Permit No. �2Z'3 t 04 .►L ; Department of Fire Services �^ ` ''1 BOARD OF FIRE PREVENTION REGULATIONS [Rev.Occupancy9/05] and Fee Checked 0 v l ''�~` (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 PRINT IN INK OR TYPE ALL INFORMATION) Date: 11/16/21 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)18 DAISY LANE Owner or Tenant ROBERT BROUTHERS Telephone No. 5086802571 Owner's Address SAME ‘.%-..qp Is this permit in conjunction with a building permit? Yes El No El (Check Appropriate Box) �..J Purpose of Building DWELLING Utility Authorization No. Existing Service Amps / Volts Overhead El Undgrd❑ No.of Meters New Service Amps / Volts Overhead El Undgrd El No.of Meters . /,,Number of Feeders and Ampacity V l Location and Nature of Proposed Electrical Work: GENERATOR 20KW Completion of the followingtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf `- Transformers KVA VA No.of Luminaire Outlets No.of Hot Tubs Generators 20 KVA No.of Luminaires Swimming Pool Above grnd. El in- ElNo.of Emergency Lighting 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. Tonal No.of Alerting Devices 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 El Connection Municipal ❑Other No.of Dryers Heating Appliances , SecuritySr stems:* No.of Devices or Equivalent No.of Water Heaters KW No.of No.of Data Wiring: 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: 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 ® BOND ❑ OTHER ❑ (Specify:) • I certify,under the pains and penalties of perjury,that the information on this ap lication is true and complete. FIRM NAME: E.F. WINSLOW PLUMBING& HEATING CO. LIC.NO.:3281C Licensee: RICHARD MELVIN Signature - LIC.NO.:21829A (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:508-394-7778 Address: 8 REARDON CIRCLE SOUTH YARMOUTH,MA 02664 Alt.Tel.No.: *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)❑owner n owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ E.F. Winslow Inspection Department email : inspections@efwinslow.com