HomeMy WebLinkAboutBLDE-22-003736 Commonwealth of Official Use Only
tf_1Ue4.4% Massachusetts Permit No. BLDE-22-003736
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:1/5/2022
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) 38 COVEY DR
Owner or Tenant CLOHESSY LISA M TR Telephone No.
Owner's Address CLOHESSY FAMILY TRUST, 38 COVEY DR,YARMOUTH PORT, MA 02675
Is this permit in conjunction with a building permit? Yes 0 No 0 (C ck %.-„ rt$'11Box)
Purpose of Building Utility Authorization N a ~,t, >�
Existing Service Amps Volts Overhead 0 Undgrd � t *r /
f
''� (
New Service Amps Volts Overhead 0 Undgrd 0 No'aflGtetets n,
Number of Feeders and Ampacity �t ` '' t
Location and Nature of Proposed Electrical Work: 220 V Disconnect, 100 V GFI outlet,25 amp double breaker, ub„ a k
' '..
Completion of the following table may be . e lit ctor of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of <' otal
Transformers Y'� KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above In- ElNo.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets 1 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. Total No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pump Number , Tons KW No.of Self-Contained
Totals: Detection/Alertinu 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 Signs 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 ❑ (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
Licensee: Joseph V Slowey Signature LIC.NO.: 11186
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 168 WATERCOURSE PL, PLYMOUTH MA 023603629 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. PERMIT FEE: $50.00
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ommonwealth o f Mamac4usett9 Official Use Use Only
=-- 1, c-� Permit No. -. 3 7:31,
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`rmOccupancy and Fee Checked
•1:ON•D OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
[.JAN Af2I A ION FOR PERMIT TO PERFORM ELECTRICAL WORK
11 ork to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
BUILDIrvfil ;p I INK OR TYPE ALL INFORMATION) Date:1/3/2022
sy.
_.. 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)38 Covey Drive
C) Owner or Tenant Lisa Clohessy Telephone No. 5083984454
V Owner's Address
-.,... Is this permit in conjunction with a building permit? Yes Ti No [ (Check Appropriate Box)
Purpose of Building Residence Utility Authorization No.
Existing Service Amps / Volts Overhead Ti Undgrd Ti No.of Meters
New Service Amps / Volts Overhead 1-1 Undgrd Ti No.of Meters
`(3 Number of Feeders and Ampacity
\ Location and Nature of Proposed Electrical Work: 220V Disconnect, 100V GFI outlet, 25 Amp double breaker
(�/1 sub panel update
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tr of TVA
U Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.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
Total
a) No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
p Totals: Detection/Alerting Devices
Municipal
`� No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other
J No.of D ers Heating Appliances KW Security Systems:*
I Y No.of Devices or Equivalent
No.of Water Heaters KW No.of No.of Data Wiring:
Signs Ballasts No.of Devices or Equivalent
dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.H
Y g No.of Devices or Equivalent
I
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 1600 (When required by municipal policy.)
Work to Start:1/3/2022 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
I 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.
SI- CHECK ONE: INSURANCE 2 BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME:JVS Electrician LIC.NO.:
Licensee: Joe Slowey Signature LIC.NO.:11186B
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:508-326-2280
Address: 168 Watercourse Place,Plymouth,MA 02360 Alt,Tel.No.:
*Per M.G.L. c. 147,s. 57-61,security work requires Depat anent of Public Safety"S"License: Lic.No.
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: $ l
Signature Telephone No. I