BLDE-22-001432 Commonwealth of Official Use Only
.i`. ,i Massachusetts Permit No. BLDE-22-001432
tz 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:9/13/2021
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) 149 DIANE AVE
Owner or Tenant Gilbert Martin Telephone No.
Owner's Address 149 DIANE AVE, SOUTH YARMOUTH, MA 02664-1924
Is this permit in conjunction with a building permit? Yes 0 No 0 (Ch ►propriate Box)
Purpose of Building Utility Authorizatio o.
Existing Service Amps Volts Overhead 0 Undgrd = ,I � ers
New Service Amps Volts Overhead El Undgrd ► 1
Number of Feeders and Ampacity A
Location and Nature of Proposed Electrical Work: Wiring for dehumidifier. 0 4 8
Completion of the following table ma 1- 11 y e Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of O Total
Transformers.? KVA
No.of Luminaire Outlets No.of Hot Tubs Generators f KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lights
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
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/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local 0 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 Eauivalent
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: 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 ❑ owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$50.00
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j c� Permit No. "Z Z— (4 3 Z
pc a Fri, Apartmsai oi.}ir t arvies.1
OccBOARD OF FIRE PREVENTION REGULATIONS [Rev.i 07cy and Fee Checked
ys �,,*� i (leave blank)
0
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),. 527 CMR 12.00
e (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: q . 8" - 2-02. 1
City or Town of: (a(movt-r-1A To the Inspector of Wires:
cP)i By this application the undersigned gives notice of his or her intention to perfonn the electrical work described below.
U I Location(Street& Number) pig e t a Ile clue 50(AT N Ni'ot r m otv1 T H
) { Owner or Tenant G tt he r-F- leaf-t-,'t1 Telephone No., g.(358.,otv 3 I
4- Owner's Address
o Is this permit in conjure on with a building permit? Yes ❑ No 7 (Check Appropriate Box)
i Purpose of Building t' €S l c 't f1 C e., Utility Authorization No.
cu l Existing Service Amps / Volts Overhead I J Undgrd ( I No.of Meters
1
New Service Amps / Volts Overhead b Undgrd ❑ No.of Meters
`> €i Number of Feeders and Ampacity ((11
i
Location and Nature of Proposed Electrical Work: c,lJ l re_ 0 e.h l.( t'11•c CI 14 1 e('
V' Completion of the followingtable may be waived by the inspector of Wires.
No.of Total
t1f No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Transformers KVA
', No.of Luminaire Outlets No.of Hot Tubs Generators KVA
4 No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighfing
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
Initiating Devices
' No.of Ranges No.of Air Cond. Total Tons g No.of Alerting Devices
No.of Waste Disposers eat Pump• umber Tons KW 'No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW al❑ Munici
Loc pal ❑
Connection thiltr
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.Of Data Wiring:
Heaters Signs Ballasts No.of Devices or Esjuivalent
No. Hydromassape Bathtubs No.of Motors Tote!liP Telecommunicatlons Wiring:
1' I No.of Devices or Equivalent
!OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 145 • (When required by municipal policy.)
Work to Start: c(• . 2,0Z( Inspections to be requested in accordance with MEC Rule l0,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 EA BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the Information on this application is true and complete.
FIRM NAME: J J S E l e c' r l c t U n 7 LIC.NO.:
Licensee: d of 310 ,�Signature " ( r/ LIC.NO.:/// 6_
ilf applicable, enter"exempt"in the license number line.)
Address: /‘ a- wate,ro,erse P/dce, ;line.)
moo-Aj, A v23ly c Bus.Tel.No.:SDu gel Co �aR.
Alt.Tel.No.:
*Per M.G.L.c. 147, s. 57-61,security work requires Department of Public Safety"S"License: Lie.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
Signature Telephone No. I PERMIT FEE: $
Official Use only
.. Commonwealth of
� ► Massachusetts Permit No. BLDE-22-001432
rni„,,,e.;7
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.l/071
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC),,5117 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:9/13/2021 e/Z'j
City or Town of: YARMOUTH To the Inspector Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below
Location(Street&Number) 149 DIANE AVE
Owner or Tenant Gilbert Martin Telephone No.
Owner's Address 149 DIANE AVE, SOUTH YARMOUTH, MA 02664-1924
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: Wiring for dehumidifier.
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 KVA
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
Initiating 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/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Heaters Signs
KW No.of No.of Ballasts Data Wiring:
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 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
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
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.:
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 ❑ owner's agent.
Owner/Agent
Signature Telephone No. !PERMIT FEE: $50.00 I