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HomeMy WebLinkAboutBLDE-22-007451 - - - �/ Commonwealth of Official Use Only fe A �7 Massachusetts Permit No. BLDE-22-007451 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/N INK OR TYPE ALL INFORMATION) Date:6/28/2022 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) 43 POND ST Owner or Tenant Blake Rubin Telephone No. Owner's Address 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: Miscellaneous work per attached. 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 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 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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: $75.00 c 7 ji 2 j?V 7 7 -353- C. P5� eq 1L-44--t� 3( mod`/ S \ Lornotonweanit 01 #1423Jachu...isits r- Official Use Only 2-z 7L+ 5 I .fi.:2 �� �1 �+.yg�N�q (''yN,`�"� �j,}f�'�'`�}/, 1 Permit i 51/+ N �C ,gS -;. .��")(/,j�'�!tM4rM Q r.... 7f+?'"ffin h�I U._5�7Ni.'v}'�Y .w ,� f Occupancy and Fee Checked ked jo BOARD F FIRE P EVE T O � REGULATIONS .��v. 1f071 tr�ki C'. kit,titli-io=0 i . APPLICATION FOR PERMIT TO PERFORM ELECTRICAL All work to be performed in accordance with the Massachusetts Electrical Code (ME ) 527ICMR 4. (PLEAS PRINT IN INKOR Y E ALL INFORMATION) C. ifLei/tel;-Lr orCity Town of: '` � To the Inspector of Wires: ti By this application the undersigned gives latziee of his or her 'ntenti'ri to perform -the electrical work described below. (Street q \ o� 5 Gt.. F i 1 CALtCy Location �. . . _ iz 12 �' Tel bone No. .�C) ' a �. Owner € r Tenant (C4 1 Owner's Address cf Z c. , t C Ai CCU aiih buildinpermit? Ye-s." ,- es No (Check Appropriate Box)-JO 1 l Is this permit in eon,�un�Ct� c, . �. lose of . �a r- f c c-A p*-' z ic.,Le Utility ' uthor ation No. Fug Building _(\t- i 0 c. (©�- '� Amps 1 Volts Overhead • li n dgr-d 11111 „"�o. of Meters fi ti sting Service � 4 New Service Amps / Volts Overhead 1 n d rd No. of Meters `t3' 1 Number of Feeders and A_npacityy ' .r - - ' . - ..P. . - ..Q 1 Location and Nature of Proposed Electrical �'ork: 0c+41c+s a j cCe 3 ,i+ U ( Pc t x.\r) * 4- 01/4Actec r- 0 Qff k't CI dcGc) Corn lesion 0 -the follow:n: table ma-v be waived by the I •ec tar of Wires. o. o ota tit No. of Recessed Luminaires ''No. of Ceil. usp. (Paddle) Fans No. of Luminaire Outlets Transformers '� r .- l.et No of mot �Tubs Generators KVA Cit Above In No. of , �mergenc Lighting 4 No. of Luminaires Swimming Pool nd. ❑ w grad. I Battery,Units I . . :it 1''r +. of Receptacle Outlets -No. of oil Burners - FIRE ALARMS INo. of Zones :. o. of Detection and No. of Switches No. of Gas Burners Initiating Dev ices _ _ A No. of Ranges . No. of Mr C.ond, Tons ! No. of Alerting Devices Heat Pump Number :Tons ( KW "No. of SelfContainer , ,........; o, of Waste Disposers Totals: DetectionJAlertiing Devices of •�hwas KW:hers SpaeelArea HeatingLocal 0 No, Connection fir ,Heating ,Appliance: Security Systems:* { No. of Dryers No. of Devices or F.. utvalent " . oaten. o Data Wiring: a. o� ' B al l asts No. of Devices or _ uivalent Heaters Signs � . . . ..� ;Telecommunications Wiring: No. f� No. of Motors Total HP No. of�►evices or f ggiyal ent l�vdrornassag� Bathtubs - Attach additional detail if desired, or as required by the Inspector of Wires. g st;mated Value of Electrical Work: t-5c _ (When required by municipal policy.) Work:. to Start: s( moiedici Inspections to be requested in accordance with MEC Rule 10, and upon completion. COVERAGE:E: Unless waived by the owner, no permit for the performance of electrical work may issue unless INSURANCE licenseeprovides proof of liability insurance including .completed operation" coverage or its substantial equivalent The the i ed certifies that such coverage is in force, and. has exhibited proof of same to the permit issuing office. ,>-- underS Ej y�'''� IA f• '}��{,i' ,, (J 4�y'w7 �w r' � �V t� G�-��V� b 0 t-�c/V� __t ONE: 7 E YTREK4 SIfl.:cif�' .) t w `'•%,W4�.I-i��'l�. �L��N�� BOND i ` ����� is true and complete. I certify, under the pains and penalties of perjury, that the informationn this application � • Litw;. ��.: �� FIRM NAME: 0 ) " t t C ft Licensee: , Signature LIC. NO.: - .11.elpfrilicabie, enter "exempt- rn the license number line.) Address: All TeL No.:__ _ ....,.. �.__._.�-._ *Per :. .L.. c. 147, s. 57-6 l , security work requires Department of Public Safety '�S' License: Lic. Rio.s coverage nu ii OWNER'S INSURANCE WAIVER: I amaware that the Licensee does not have the liability insuranceagent., ly .. ow, I waive this requirement. I am the (check one) 0 owner { _ owner's required by law. B m a �e b 1 hereby Owner/Agent gent No� � v�7`-� I PERMIT FEE: $ • j A _ Telephone Elliott, Ken From: Blake J. Rubin <blake.rubin.law@gmail.com> Sent: Thursday, July 7, 2022 7:41 PM To: Elliott, Ken Subject: Re: 43 pond street inspection Attention!:This email originates outside of the organization. Do not open attachments or click links unless you are sure this email is from a known sender and you know the content is safe. Call the sender to verify if unsure. Otherwise delete this email. Hi Ken we can make that work ! Thank you Blake J. Rubin Attorney at Law 120 Main Street Worcester, MA 01608 Office: 508.925.0005 Fax: 508.796.3845 Rubin@AttorneyRubin.com AttorneyRubin.com On Jul 7, 2022, at 3:00 PM, Elliott, Ken <KElliott@yarmouth.ma.us>wrote: The first available appointment that I have open would be Tuesday,July 12 or sometime later in that week. Please advise what works for you. K. Elliott Inspector of Wires Town of Yarmouth, Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 (Extension 1263) kelliott@yarmouth.ma.us From: Blake J. Rubin <blake.rubin.law@gmail.com> Sent:Thursday,July 7, 2022 12:42 PM To: Elliott, Ken <KElliott@yarmouth.ma.us> Subject: Re: 43 pond street inspection Attention!:This email originates outside of the organization. Do not open attachments or click links unless you are sure this email is from a known sender and you know the content is safe. Call the sender to verify if unsure. Otherwise delete this email. 1 Hi Ken the electrical is ready for inspection please.The permit should be on file.I'm around this week if you have time.Thanks Blake 508-713-2223. Blake J.Rubin Attorney at Law 120 Main Street Worcester,MA 01608 Office:508.925.0005 Fax:508.796.3845 Rubin@AttorneyRubin.com AttorneyRubin.com On Jun 22,2022,at 3:10 PM,Blake J.Rubin<blake.rubin.law@amail.com>wrote: Hi Ken;Sorry didn't know needed it.I have the other permit.Is is possible to get a blank one on-line.I can fill it out and send it in.Thanks,Blake Blake J.Rubin Attorney at Law 120 Main Street Worcester,MA 01608 Office:508.925.0005 Fax:508.796.3845 Rubin@AttornevRubin.com AttorneyRubin.com On Jun 22,2022,at 1:24 PM,Elliott,Ken<KElliott@varmouth.ma.us> wrote: I do not have any sign of a permit application for this location.I will need something submitted and processed before I can schedule an appointment. Thank you and have a GREAT Day! K.Elliott Inspector of Wires Town of Yarmouth,Building Department 1146 Route 28 South Yarmouth,MA 02664 (508)398-2231 (Extension 1263) kelliott@varmouth.ma.us 2 From: Blake J. Rubin <blake.rubin.law@grnail.com> Sent: Monday, June 20, 2022 11:52 AM To: Elliott, Ken <KElliott@yarmouth.ma.us> Subject: 43 pond street inspection Attention!: This email originates outside of the organization. Do not open attachments or click links unless you are sure this email is from a known sender and you know the content is safe. Call the sender to verify if unsure. Otherwise delete this email. Hi Ken the electric is ready for an inspection. When would you like to do this. I'm back and forth to the house or I could have my handyman friend meet you at the place. Blake J. Rubin Attorney at Law 120 Main Street Worcester, MA 01608 Office: 508.925.0005 Fax: 508.796.3845 Rubin@AttorneyRubin.com AttorneyRubin.com 3