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HomeMy WebLinkAboutBLDE-22-001491�* VCommonwealth of Official Use Only Massachusetts Permit No. BLDE-22-001491 a_ 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/ 15/2021 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 a ectrical work described below. Location (Street & Number) 53 LEWIS BAY BLVD Owner or Tenant DAMICO JOSEPH A TRS Telephone No. Owner's Address DAMICO ZABELLE G, PO BOX 41, HOLDEN, MA 01520-0041 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ 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 Above ❑ Iand ❑ No. of Emergency Lighting Batter its 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 Initiatin D vices No. of Ranges No. of Air Cond. Tonal Tos No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number Tons KW No. of Self -Contained Detection/Alertin2 Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No. of Dryers Heating Appliances KW Security Systems:* NINQ. Of Devices or Eauivalent No. of Water KW Heaters No. of No. of Ballasts ins Data Wiring: No. of Devices or Eauivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: of Devices or Eauivalent 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 ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: RICH M MELVIN Licensee: Rich M Melvin Signature LIC. NO.: 21829 Qf applicable, enter "exempt" in the license number line.) Bus. Tel. No.: Address: 8 REARDON CIR, S YARMOUTH MA 026641207 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 signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. IPERMIT FEE: $50.00 But my Commonwealth of MassachusettsOWN Official Use Only Department of Fire Services Permit No. �%22 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] 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: 9/8/21 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) 53 LEWIS BAY BLVD, WEST YARMOUTH Owner or Tenant JOSEPH DAMICO Telephone No. 5087751889 Owner's Address SAME Is this permit in conjunction with a building permit? Yes ❑ No ❑✓ (Check Appropriate Box) Purpose of Building DWELLING Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 22KW GENERATOR No. of Meters No. of Meters Com letion o the oflowing table mav be waived b the Ins ector nf 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 22 KVA No, of Luminaires Swimming Pool Above n- rnd. ❑ rnd. ❑ No. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o Detection an Initiating Devices No. of Ranges TotaF— No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers eat Pump Totals: Number Tons o, o Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW SecuritySystems:* No. of Devices or Equivalent o. of Water Heaters KW No. o o. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP TelecommunicationsWiring: No. of Devices or E uivalent 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 NEC 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 andpenalties ofperjury, that the information on thlication is true and complete. FIRM NAME: E.F. WINSLOW PLUMBING & HEATING CO., 1 is ap LIC. NO.: 3281 C Licensee: RICHARD MELVIN Signature LIC. NO.: 21829A (Ifapplicable, 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)F] owner Downer's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ E.F. Winslow Inspection Department email: inspections@efwinslow.com