HomeMy WebLinkAboutBLDE-23-000566 Commonwealth of Official Use Only
Permit No. BLDE 23 000566
1 Massachusetts
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:8/3/2022
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) 128 CAMP ST ‘4:;)Owner or Tenant PERRONE DAVID F Telephone n ! .*_.
�r
Owner's Address 105 BLUE ELDER DR, MOUNTAIN TOP, PA 18707 O
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate B'
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Mete 9
New Service Amps Volts Overhead 0 Undgrd 0 No.of Metei 40 <71)
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: HVAC /A
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 Tons
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers Totals: Detection/Alerting Devices
Municipal ❑ Other:
No.of Dishwashers Space/Area Heating KW Local ❑ Connection
Security Systems:*
No.of Dryers Heating Appliances KWNo.of Devices or Equivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Signs No.of Devices or Equivalent
Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors I otal 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 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 I PERMIT FEE: $50.00
Signature Telephone No.
//�� pp // Official Use Only
l,onanwnwealtI o/7adiachuiettb
*== l c cc�7 Permit No. %/ '
-01_ Thepartment of ire Servicee Occupancy1/07] and Fee Checked
C , BOAiiirtRD OF FIRE PREVENTION REGULATIONS [Rev.IMO (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:8/1/2022
City or Town of: Yarmouth To the Inspector of Wires:
FBy this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number)128 Camp Street
0 Owner or Tenant Vin Perrone Telephone No. 508-579-8909
Owner's Address
ZS Is this permit in conjunction with a building permit? Yes I I No V (Check Appropriate Box)
E Purpose of Building Residence Utility Authorization No.
Existing Service Amps / Volts Overhead I I Undgrd I I No.of Meters
1 New Service Amps / Volts Overhead Undgrd I I No.of Meters
9) Number of Feeders and Ampacity
k.
Location and Nature of Proposed Electrical Work: Wire gas furnace, replace 220V disconnect and whip,
4 110V to furnace and low volt wiring to controls
Completion of the following table may be waived by the Inspector of Wires.
No.of Total
c) No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans _Transformers KVA
t.) No.of Luminaire Outlets No.of Hot Tubs
Generators KVA
Q) Above In- No.of Emergency Lighting
No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
to No.of Detection and
No.of Switches No.of Gas Burners Initiating Devices
�7 Total No.of AlertingDevices
No.of Ranges No.of Air Cond. Tons
Heat Pump I Number 'Tons 1KW No.of Self-Contained
No.of Waste Disposers Totals: i Detection/Alerting Devices
0 Municipal
No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other
�"' No.of Dryers Heating Appliances KW Security Systems:*No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaters KW Signs 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: 575 (When required by municipal policy.)
Work to Start:8/1/2022 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 Q/ BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is trueand NOlete.
FIRM NAME:JVS Electrician LIC.NO.:11186B
Joe Slowey Signature i L' 4, :11186B
Licensee: Bus.Tel.No..
(If applicable, enter "exempt"in the license number line.) v 326-2280
Alt.Tel.No.:
Address: 168 Watercourse Place,Plymouth,MA 02360
*Per M.G.L. c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'Sally
INSURANCE WAIVER: I r waive this requirement. I am the(check one)e that the Licensee does not have the liability 1❑owner coverage❑ownenors agent.
required byy I hereby law. By my signature below, yI PERMIT FEE: $�'f
Owner/Agent Telephone No.
Signature