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Home My WebLink AboutBLDE-22-001274 Commonwealth of Official Use Only Ini ttta Massachusetts Permit No. BLDE-22-001274 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:9/6/2021 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) 27 BLUE ROCK RD Owner or Tenant PHIPPS PAMELA F Telephone No. Owner's Address 27 BLUE ROCK RD, SOUTH YARMOUTH, MA 02664-1334 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 addition&add split At system. 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 grad. 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 Initiatine Devices No.of Ranges No.of Air Cond. 1 TotaloNo.of Alerting Devices 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 Eauivalent 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:324 Oak Street, Harwich MA 02645 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 g167 Kg 4RFCEIVED SEP 0 " 2121 l.ommonwea[th of 1//addac�iudsttd Official Use Only _.... �, ��. s e22-(27 4 B U i D i"J C� U.■ ;41',,,.....h^ T 2spartmanf o ire srvicsd Occupancy and Fee Checked ` :OARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( MEC,5 7 CM 12.00 g (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9)/2 z.[ ....s 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) Z 7 f (vc Rot Rd Owner or Tenant pa;,y, fi, p S Telephone No. Owner's Address IN Is this permit in conjunction with a building permit? Yes ',a No ❑ (Check Appropriate Box) Purpose of Building „/ 11'„1 Utility Authorization No. Existing Service /176 Amps Volts Overhead all Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: i.•,,/tY, to d oi t:661-‘ et IA d h to 'G_ Completion of the followinktable m Inspector of Wires. NA No.of Recessed Laminaires No.of Cell.-Soap.(Paddle)Fans No.of be waived by the Total nl Transformers KVA ':t No.of Luminaire Outlets No.of Hot Tubs Generators KVA N. ,t” No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting Rind. grnd. 0 Battery Units �` No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches No.of Gas Burners No.of Detection and i t r Initiating Devices No.of Ranges No.of Mr Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number ETons KW No.of Self-Contained Totals: _...._...._... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Connection Municipal ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: • No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 06 D (When required by municipal policy.) Work to Stan: 9/2._ 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 a 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: Licensee: e..,4-1 LIC.NO.: ► 1 Ina, Signature GT / LIC.NO.:_________S-7..)__ ZZ (If applicable,enter"exempt"in the license number li e.) i3 Address: 2--Y (7 e,(� Srt'i v ,c, , /''� S S <72-6ys' Bus.Tel.No.: v S 71 g H *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt 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,l hereby waive this requirement. I am the(check one Owner/Agent owner ■ owner's a.ent. Signature Telephone No. PERMIT FEE:$