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HomeMy WebLinkAboutBLDE-22-001324 Commonwealth of Official Use Only ki,tik co Massachusetts Permit No. BLDE-22-001324 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:9/7/2021 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) 8 JOYCE ST Owner or Tenant SWANSON RUSSELL TRS Telephone No. Owner's Address SWANSON ELIZABETH H TRS, 8 JOYCE ST, 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: Replacement boiler&add split A/C Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting No.of Luminaires grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 1 No.of Detection and No.of Gas Burners No.of Switches Initiating Devices No.of Air Cond. 1 Total No.of Alerting Devices No.of Ranges Ton Heat Pump Number Tons 1 KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Municipal ❑ Other: No.of Dishwashers Space/Area Heating KW Local 0 Connection Security Systems:* No.of Dryers Heating Appliances KW No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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: JOSEPH V SLOWEY LIC.NO.: 11186 Licensee: Joseph V Slowey Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address: 168 WATERCOURSE PL, PLYMOUTH MA 023603629 *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 o liability insurance coverage en normally required by law.But my s signature below,I hereby waive this requirement.I am the(check one) I Owner/Agent `PERMIT FEE: $50.00 Signature Telephone No. 0 A 1/7 7 � RECEIVED A., --- — 15nsmonionnsig el Ogneetscludeeite + Official Use Only ,• ' *palmed �] /. iro Services ....- Occupancy and Fee Checked PRI v "", ._ D1 ( /i tirOli E. PREVENTION REGULATIONS [Rev. 1/07] (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: 9, 7, 07/ City or Town of: .N q 1111 b u To the Inspector of Wires: ( By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Al Location(Street&Number) ?' c)QYCe 5T 56U1":1-1 'a cm Cite(T k v Owner or Tenant Rlt A S 5 wan 5h,,,--' Telephone No. 2-, 737.O(p(0Ll Owner's Address ©` ! Is this permit in conjunction with*building permit? Yes 0 No I t�I A (Check Appropriate Box) 6 Purpose of Building RfS►cteY1ce., Utility Authorization No. 1 Existing Service Amps / Volts Overhead El Undgrd 0 No.of Meters vi New Service Amps / Volts Overhead❑ Undgrd © No.of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: w 1(L Q k r 1.U1 re /1-C D'SCo nneC t -coe' It I* ab�shi min NI* slit Completion of the followin table may be waived by the Inspector of Wires. oral tlf No.of Recessed Luminaires No.of Cell.-Strap.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- 1vo.of t,mergency LigNting it' No.of Luminaires Swimming Pool grad. grad. � Battery Units r No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones It o.of Detection and . No.of Switches No.of Gas Burners Initiating Devices nd 1 U No.of Ranges No.of Air Cond. T© No.of Alerting Devices Heat Pump Number_Tons ,._KW a.of Self-Contained No.of Waste Disposers Totals: Dettection/Aler��ia�Devices M No.of Dishwashers Space/Area Heating KW Local 0 Connectionunidpai 0 Other Heating AppliancesKW Security Syystems} No.of Dryers H g No.of Devices or Equivalent No.of Water KW ©.of No.of Data Wiring•. Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: 13` (When required by municipal policy.) Work to Start: i 1 • al Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE GE: Unless waived by the owner,no permit foperation"perf of electrical work may issue unless the licensee provides proof of liability insurance including"completedcoverage 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: INSURANCES] BOND 0 OTHER 0 (Specify:) I certijfy,under the pains and penalties of that the bgbriwation on this application is true and complete. FIRM NAME: . '15 eVecTr 1 c.t a h LIC.NO.: licensee: kj oe_ S l ova'' Sign , t Is' LIC.NO.: /%1 no6 „ ature f ' Bus.TeL No.:,�t'c3Ne o2. rYD (!f applicable,enter"extra in the license numberline.) Alt.Tel.No.:Address: J( walfreOUrst Place P/ym�M, mafPnbl' Safety"S„License: Tel.No.: *Per M.G.L.c. 147,s.57-61,security work/requires Department 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)0 owner a owner's agent. Owner/Agent Telephone No. I PERMIT FEE: $ Signature