HomeMy WebLinkAboutBLDE-21-004649 Commonwealth of Official Use Only
,, Massachusetts
Permit No. BLDE-21-004649
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:2/16/2021
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to pertorm the electncal work described below.
Location(Street&Number) 54 HARBOR RD
Owner or Tenant KEELEY DENNIS L TR Telephone No.
Owner's Address HARBOR ONE RLTY TRUST,47 GARNET RD,WEST ROXBURY, MA 02132
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 o.of Meters
New Service Amps Volts Overhead 0 Undgrd 0 Ito.o eter,/
Number of Feeders and Ampacity2.
/(
Location and Nature of Proposed Electrical Work: Replacement boiler&furnace. O
Completion of the following t 1 t�b iv•i e r of Wires.
No.of Recessed Luminaires No.of Ceil:Sus . Paddle Fans No.of as
p( ) Transformers427, YQVA
No.of Luminaire Outlets No.of Hot Tubs Generators a A
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grad. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners 2 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 ❑ 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 Data Wiring:
Heaters Signs Ballasts 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.: 11 186
(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
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
N7A to (ici(24 ,
ACommonwealth all ae Maac u udis Official Use Only
0. . 'r cc�� c-� {� Permit No. "---( —Li L 7
.1aspartmsni of_}irs..7swiceo
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/07] (leave blank)
�; APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
- Alt work to be performed in accordance with the Massachusetts Electrical Code NEC),527 CMR 12,00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: a . I a i aoa 1
City or Town of: �Jct r (T 0.\T I { To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
0-7
Location(Street&Number) 3 4 \A C i r be r tad
(10.").,,
I 4.) Owner or Tenant 0 e on Is te,‘ Q./ Telephone No. 17, `t6. , i315
,.. : Owner's Address
1 (4- t Is this permit in conjunction with a building permit? Yes ❑ No [ (Check Appropriate Box)
Purpose of Building Re 5 i d eC-e- Utility Authorization No.
.J ` Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters
v —
New Service Amps / Volts Overhead 0 Undgrd No.of Meters
0 i Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: w1'(t ?GI \e r CA.Vna ��1N,C 11Cole L(_•
Completion of the followin1,table mcxy be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Cell.-Soap.(Paddle)Fans No.of Total
� Transformers KVA
L No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Above ❑ In- ❑ No. Emergency Lighting
No.of Luminaires Swimming Pool In-
trod. grad. Batteryof Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
1 -. No.of Switches No.of Gas Burners jNo.of Detection and
" Initiating Devices
1 Total
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
'Heat Pump Number Tons KW . 'N i.of Self-Contained
No.of Waste Disposers Totals: Number__ ........ Detection/AlertingDevices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ t other
Connection
No.of Dryers Heating Appliances KW Security Systems:1
No.of Devices or Equivalent
No.of Water KW 'No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage BathtubsINC.of Motors Total HP ;Telecom municafor.! iring.
1 No.of Devices or Equivalent
OTHER:
J
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (Q 1`� (When required by municipal policy.)
Work to Start: 6), 1,,. ,9)a,I 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 ® 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'\l S It?C 1R 1 L I Ci►1 LIC.NO.:
Licensee: . J 0 e . LTD t A='P�1 Signature, Gv4,Z4L5' LIC.NO.: 1/18'(j'6(If applicable,enter"exempt'in the lic nsen umber line.) Bus.Tel.No.'S2,R'`-1,74 338-6
Address: /ii' VValer"C'C./Rc- t tic(1 I-2y(/11G1��71 /9 G',:*36L.) Alt.Tel.No.: _.
*Per M.G.L.c. 147,s.57-61,security work requires'Department 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
Signature Telephone No. PERMIT FEE: $