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Home My WebLink AboutBLDE-22-000096 Official Use Only r Commonwealth of Permit No. BLDE-22-000096 -: 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:7/7/2021 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) 10 BLUE ROCK RD Owner or Tenant SHEA JOSEPH M Telephone No. Owner's Address 10 BLUE ROCK RD, SOUTH YARMOUTH, MA 02664 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 of air exchanger in basement. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ Ign-nd. ❑ No.of Emergency Lighting r Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump 1 Number I l Tons I KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Municipal ❑ Other: No.of Dishwashers Space/Area Heating KW Local ❑ Connection Security Systems:* No.of Dryers Heating Appliances KW No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: KW Signs Ballasts No.of Devices or Equivalent Heaters Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 LIC.NO.: 53620 Licensee: MATTHEW D KLINE Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:324 Oak Street, Harwich MA 02645 *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 oWi liability ity insurance coveragee normally required by law.But signature below,I hereby waive this requirement.I am the(check one) I Owner/Agent I PERMIT FEE: $50.00 Signature Telephone No. RECEIVED JUL 0 7 2021 Official Use Only BUILDING D E•:.:.�t i E N T Commonwsa[tk 4///Qeear�ud°�"b �?�,�190 O pt By._. _ c� {� Permit No. / wv ? 2epartmani of.iris Servresd Occupancy and Fee Checked 1 1 BOARD OF FIRE PREVENTION REGULATIONS (Rev. 1/07J (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK . All work to be performed in accordance with the Massachusetts Electrical Code(ME ,527 CMR 12.00 . (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7�(v 7-24 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice_of his or her intention to performr the electrical work described below. Location(Street&Number) 10 Ij (v f 'ko v� ( C' Owner or Tenant \1 c vt A L 5 t,, Telephone No. . i 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❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd El No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: wI I'!zi_, e v-V 1 t?i r!'I 41 M co vitt f p y•zit Loy" " aQ i i IL _ (:.'eflc,r 411 '. Completion of the following table may be waived by the Inspector of Wires. til No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of TotalTransformers KVA Zt No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grad. ❑ grnd. ❑ Battery Units .i No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS No.of Zones Na.of Gas Burners 'No.of Detection and No.of Switches Initiating Devices l 1, Total i No.of Ranges No.of Air Cond. Tons No.of Alerting Devices Heat Pump Number Tons .._..,KW No.of Self-Contained No.of Waste Disposers Totals: -'-' Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Ot6er HeatingAppliances KW Security Systems:* No.of Dryers pp No.of Devices or Equivalent No.of Water s KW No.of No.of Data Wiring: Heater Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. required bymunicipal policy.) Estimated Value�f Electrical Work: l,� (When �i p p y' Work to Start:? (a z 1 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 I BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and LIC.complete. FIRM NAME: NO.: Licensee: il c,-it 11-_1,>sk-• Signature LIC.NO.: S.I 4, c7 i3 Bus.TeL No.: -5 J?. VS 71-511 (If applicable,enter"exempt" ' tile licens umber line.) _ 4.0 Address: 3'2 LI �� ♦{trvv> 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 owner's agent.I Owner/Agent Telephone No. I PERMIT FEE:$ Signature