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Home My WebLink AboutBLDE-20-001137 or Commonwealth of Official Use Only il't - Massachusetts Permit No. BLDE-20-001137 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) City or Town of: YARMOUTH Date:8/29/2019 By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below.r of Wires: Location(Street&Number) 176F WINSLOW GRAY RD Owner or Tenant RUHAN JAMES F Owner's Address RUHAN THOMAS J, 168 SOUTH ST, SOUTH YARMOUTH, MA 02664 Telephone No. Is this permit in conjunction with a building permit? Purpose of Building Yes 0 No 0 (Check Appropriate Box) Amps Utility Authorization No. Existing Service Am P Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Number of Feeders and Ampacity Overhead 0 Undgrd 0 No.of Meters Location and Nature of Proposed Electrical Work: Repair cut wires after house lift. 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 Transformers Total No.of Luminaire Outlets No.of Hot Tubs '` Generators KVA No.of Luminaires SwimmingPool Above In- My! ❑ grnd. o No.of Emergency Lighting No.of Receptacle Outlets Battery Units No.of Oil Burners FIRE ALARMS !No.of Zones No.of Switches No.of Gas Burners No.of Detection and No.of Ranges Initiating Devices No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW Totals: No.of Self-Contained No.of Dishwashers Detection/Alerting Devices Space/Area Heating KW Municipal Local 0 P 0 Other: No.of Dryers Connection Heating Appliances KW Security Systems:* No.of Water KW No. No.of Devices or Equivalent Heaters N ofs No.of Data Wiring: Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work to start: (When required by municipal policy.) 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 o perjury,u that the information on this application is true and complete. FIRM NAME: MATTHEW D KLINE p J Licensee: MATTHEW D KLINE (If applicable,enter'exempt"in the license number line.) Signature LIC.NO.: 53620 Bus.Tel.No.: Address: 10 Nehoiden St, Harwich Port MA undefined 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 Owner/Agent ) 0 owner 0 owner's agent. Signature Telephone No. PERMIT FEE:$50.00 acmes aP c`J 401(9 lC __. i. = = _ �1i '� Official Use On! —_fit_ n :t �`pRt o Jw rich Permit No. C 3 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked -'. .. 1 •cv. 1/07] cave blank -- APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (PLEASE PRINT IN INK OR TYPE ALL INFO (ME 527 / 12.110 City or Town of: AR_ �� RMATION) Date: ��/19 By this application the undersigned edMOUTH To the Inspector of Wires: gn gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) j; / 1 10 6YC. Owner or Tenant * } Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No Purpose of Building Cf -e-I it' ❑ (Check Appropriate Box) Existing Service Utility Authorization No. 'fs ---� Volts Overhead ❑ Und d Newer Ce Amps 1 �' ❑ No.of Meters Volts Overhead❑ Undgrd� ❑ No.of Meters _ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Wont , Thnooll ; embo.oecessed Luminaires e waived No.of Ceil.-S • e I • for o Wires, usp.(Paddle)Fags o•of Total No.of Luminaire Outlets Transformers ICVA No.of Hot Tubs No.of Luminaires Generators I{VA Swimming Pool Above ❑ 0 B In- `atte IIaits o.a Units cy _ ring No.of Receptacle Md' `mid• ep de Outlets No.of Oil Burners No. IMEIMMIof Switches No,of Zones No.of Gas Burners `o.of Detection and No.of Ranges Initis. _ Devices Na of Air Cond. ° ' No.of Waste D' Tons No.of Alerting Devices Disposers Heat Pump umber Tons Totals: o,of elf omni. No.of Dishwashers DetechoNAlertin• Devices Space/Area Heating KW Local❑ Municipal No.of Dryers Heating PPA haaces Connection Othe- No.of ater , Security Systems:* Heaters KW No,o o.of No.of Devices or E.uivaleat Si• s Ballasts Data Wiring: No.Hydromassage Bathtubs Total HP Na of Devices or E.un alert No.of Motors Telecommunications Wiring: OTHER: No.of Devices or •uivalent • Estimated Value of Electrical Work Attach additional detail ifdesired or as re Work to Start: required by municipal policy.)required by the Inspector of Wires Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE : Unless waived by the owner,no the licensee provides proof of liability insurance including°r permit for the performance mance of electrical workamay issue unless undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing g completed operation"coverage or its substantial equivalent. The CHECK ONE: INSURANCE ❑ BOND I�rnfy, under the pains and penalties ❑ OTHER ❑ (Specify:) office. o FIRM NAME: penury,that the information on this application is true and complete Licensee: -c LIC.NO.: (If applicable,enter"exempt"in5the licensjrSignature ''� �_. Address 2 c� Jmb r line.) LIC.NO.: � l Per M.G.L. c. 147,s.57-61,secant �'' Bus.Tel.No.:._"d d=s- i,r ,Q OWNER'S INSURANCE WA security work requires Department of Public Safe Alt.Tel.No.: y OWNER'S by law. By WAIVER: I am awareto e License: Lic.No. mysignature the Licensee does not have the liability insurance coverage Owner/Agent by gnature below,I hereby waive this requirement I Be nonnall eq am the(check one 0Y l� signatureowner 0 owner's a_enL Telephone No. PERMIT FEE: $