HomeMy WebLinkAboutBLDE-23-004130 Commonwealth of Official Use Only
EL. ; Massachusetts Permit No. BLDE-23-004130
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:1/26/2023
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. r,t
Location(Street&Number) 17 JOYCE ST `
Owner or Tenant GLEASON MICHAEL F Telephone No
Owner's Address GLEASON ANGELA, 8 WELCH AVE, RUTLAND, MA 01543 �y
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 heat pump.
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 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: 1 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 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 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 LW.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
Commonwealth o/11/aaeaciLiett9 Official Use Only
n / c� Permit No. 2 Us 7 —LA 130
.2)epartment o/3ire Servicee
e E._�_f_ Occupancy and Fee Checked
'aaJ �s,� BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/07] (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:1/23/23
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. --G
Location(Street&Number)17 Joyce Street rp
Owner or Tenant Angela and Mike Gleason Telephone No. 774-239-9217
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) 01
Purpose of Building Residence Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Q
New Service Amps / Volts Overhead ElUndgrd ElNo.of Meters ~
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Wire Heat pump for mini splits. .
220V disconnect, 110V GFI outlet,35 AMP breaker.
Completion of the followinQtable may be waived by the Inspector of Wires. 1
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf T
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
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
No.of Switches No.of Gas Burners No.of Detection and C..Initiating Devices
Tot
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices N
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
p Totals: Detection/Alerting Devices 05
Municipal
No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other
No.of Dryers Heating Appliances KW Securi No o Systems:*
Devi es or Equivalent t1
No.of Water No.of No.of Data Wiring: •
Heaters KW Signs Ballasts No.of Devices or Equivalent
dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: 0
No.H
Y g No.of Devices or Equivalent fi
OTHER: "h
Attach additional detail if desired,or as required by the Inspector of Wires. n
Estimated Value of Electrical Work: 1000 (When required by municipal policy.)
Work to Start:1/23/23 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:) 3
I certify,under the pains and penalties of perjury,that the information on this application is true and complete. Q
FIRM NAME:JVS Electrician LIC.NO.: ^....
Licensee: Joe Slowey Signature
{jj (i.��� LIC.N0.:111866 '•8
(If applicable,enter"exempt"in the license number line.) ! Bus.Tel.No.:508-326-2280 0
Address: 188 Watercourse Place,Plymouth,MA 02360 Alt.Tel.No.: 3
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. J
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:s5.00
Signature Telephone No.