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Home My WebLink AboutBLDE-20-005401 a Commonwealth of Official Use Only Permit No. BLDE-20-005401 E Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:4/13/2020 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) 46 GINGERBREAD LN Owner or Tenant KLUG STEPHEN L Telephone No. Owner's Address KLUG MARY MARGARET,46 GINGERBREAD LANE,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appr I , . : : > Purpose of Building Utility Authorization No. O Existing Service Amps Volts Overhead 0 Undgrd 0 4Ste I w New Service Amps Volts Overhead 0 Undgrd 0 e a MOP Number of Feeders and Ampacity V.,'16 , Location and Nature of Proposed Electrical Work: Renovations of second floor bath rooms. ' O Completion of the following table may be waived by the . , Wires. No.of Recessed Luminaires 4 No.of Ceil:Susp.(Paddle)Fans No.of T Transformers KVA No.of Luminaire Outlets 4 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- CINo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 2 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 6 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 ❑ 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: BRIAN A SMITH Licensee: Brian A Smith Signature LIC.NO.: 24307 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:20 GELDING CIR, BARNSTABLE MA 026301503 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: $75.00 (i2-00Cavi ((0(2-0 M ,-tmck-1 [9-cl, +3 31 361 2-0 Com+norwvalth o//f/assaciradetts • 9 cial Use On n A'(10 � 0 ( Mi Apartment o/ L J Permit No. aP J srvicsd BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07) (leave 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 INFORMATION) Date: c3 C),5 7 CMR l 2.00 City or Town of: YARMOUTH "7�� To the I ec •r air:'..., By this application the Imdersigned gives noti e of his or her intention to perform the electrical • oi E o Location (Street&Number) 7(o /,'/ 'orf , ice% Owner or Tenant 7 _ A l ho I I ■ Owner's Address _./Aa- Is this permit in conjunction with a building permit? Yes � No 0 (Ch MIR 011,111111 of Building �/eli Utility Authorization No. Existing Service /a Amps y)/AO Volts Overhead lid" Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: G✓/ itl O -/moi .(��9,-V-i:eal/)'s Completion of the following table may be waived by the Inspector No.of Recessed Luminaires No.of of Woes, No.of Ceil.-Susp.(Paddle)Fans Total "N( Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA - No.of Luminaires / SwizQg pool Above ❑ In- No.of Emergency Lighting grad. arnd. ❑ Battery Units No.of Receptacle Outlets t No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 6 No.of Gas BurnersNo.of Detection and Initiating Devices No.of Ranges No..of Air Coed. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons 1 KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal , Connection ❑ Otlt7 No.of Dryers Heating Appliances , Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters ' Sighs Ballasts Data Wiring: l No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - ' , OTHER: No.of Devices or Equivalent Attach additional detail ff derired or as required by the Inspector of lVIres. Estimated Value of Electrical Work (When required by municipal policy.) Work to Start: 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 4 undersigned certifies that such cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE LE B OND ❑ OTHER 0 (Specify.) I certify, under the pains and pen s of perjury,that the information on this application is true and complete. FIRM NAME: ff4 f- ✓/y7 ZJ lies-- IP LIC.NO.: Licensee: 41-1" Signatur . �� i� (If applicable,enter '- -m.t"'n the license numbe line.) "�—� LIC.NO.: Address _ D ,C a r Bus.Tel.No.: . J *Per M.G.L. c. 147,s.57-61,securitywork requiresT Alt.Tel.No.: Department of Pub tc Safety"S"License: Lic.No. ..4z OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n�onnally— required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent Owner/Agent ( PERMIT FEE: $ ,5 `(f� 1 I Signature Telephone No.