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Home My WebLink AboutBLDE-21-005510 kt ..; ommonwealth Of64 official Use Only E ' �� MassachusettsPermit No. BLDE-21-005510 ;•�, BOARD F 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:3/25/2021 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) 11 KINGSBURY WAY Owner or Tenant GARB JAMES R TRS Telephone No. Owner's Address , KAIE SHEILA A TRS, 11 KINGSBURY WAY,YARMOUTH PORT, MA 02675-1227 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Relocate service&wire second floor addition. _ 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 1 Tons 1 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 Siens 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: MATTHEW D KLINE Licensee: MATTHEW D KLINE Signature LIC.NO.: 53620 (If applicable,enter"exempt"in the license number line.) 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $125.00 -" " Q- 6tet(z ing Pow 4/ 5(7, 2-1`'‘..� COmxmo wealIh o/ /rlccuachwatki Official Use Only C// n it X21" 9Sl O cc�� -'�� \j Permit No. .L'a arbnanl o��ira J6r1/icaJ �,�`=�� -.r Occupancy and Fee Checked '''"'� /I7 BOARD OF FIRE PREVENTION REGULATIONS (Rev. 1/071 (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 PE ALL INFORMATION) Date: .3/ L y /7_,1 City or Town of: YR(fr.->6'w To the Inspector of Wires: By this application the undersigned gives notice of,his or her iptertion to perform the electrical work described below. Location(Street&Number) +I K A J S 0"i r " Sala I is K 9>r,�'Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes L No CI (Check Appropriate Box) Purpose of Building 7�'1\t1 Utility Authorization No. Existing Service /00 Amps / Volts Overhead® Undgrd 0 No.of Meters New Service /06 Amps / Volts Overhead 0 Undgrd,12. No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �' `j '�1 ''Z q Completion of the following table may be waived by the Inspector of Wires. No.oTotal No.of Recessed Luminaires No.of Ceil.-Susp. (Paddle)Fans KVA Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA gra No.of Luminaires Swimmin Pool Above ❑ In-grnd. B❑ No.ofatteryUnEmeritsgency Lighting g No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones ofnd No. of Switches No.of Gas Burners No. In Detection Initiating Devices es No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Nunl¢ct_,__Tons_i _ . .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 No.of No.of Data Wiring: Heaters KW 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: 7 to (When required by municipal policy.) Work to Start: 3/2-1 Inspectidns 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:) /certify,under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: vak li a Signature �"-- LIC.NO.: S-3 L Zo-!3 (If applicable, enter"exempt"in the license number line,) Bus.Tel.No.: 5 C'g GIS- '7IS1-1. Address: %2--`f 12d k Si- v w" 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) 0 owner 0 owners agent. Owner/Agent PERMIT FEE: $ Signature Telephone No.