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Home My WebLink Aboutble-22-006115 Commonwealth of Official Use Only Permit No. BLDE-22-006115 a � ,�; 4) 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:4/25/2022 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) 51 SMITHS POINT RD Owner or Tenant LI WINIFRED I TR Telephone No. Owner's Address CIO HERSHEY BARRY J, 381 GARFIELD RD,CONCORD, MA 01742 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: Remodel second floor of guest house. 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 Initiatine Devices No.of Ranges No.of Air Cond. Ton l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons • KW No.of Self-Contained Totals: Detection/Alertina 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 Ballasts Data Wiring: Heaters Siens 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 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:$75.00 Iriliky610 412422-- (ise•Viiii...L-t5i4e-4-40 l'71-4 ---.P1=4-41,14e-); _.- / --'g (.. IA)I2f-$, R-e_rj, 6,r- P°1-L RECEIVED AP 22 14 Commonwealth of i//amachudettdp}ficia}�se(nl BL IL-DING DEPARTMENT y *i';i; ft22—(0 c� cc'77 �7 Permit Nis c -= 1b•i ; 6 .. epartmsnt° iro Serviette sy •�� a,l l Occupancy and Fee Checked %,�-"t , BOARD OF FIRE PREVENTION REGULATIONS (Rev. 1/07] (leave blank) i 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: `f/ZO/-Z-L P City or Town of: YARMOUTH To the Inspector of Wires: / By this application the undersigned gives notice f his or her intention to perform a electrical w rk described below. Location(Street&Number) 5 St,,,-r. ,, p�, p tj rem 1S lei 1„t Owner or Tenant coy'n, .6 2reM Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes ® No 0 (Check Appropriate Box) iN Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd g ❑ No.of Meters Q New Service Amps / Volts Overhead❑ Undgrd Number of Feeders and Ampacity g El No.of Meters K. Location and Nature of Proposed Electrical Work: ( �� a 4 i/t./l y'-e/ /-�w16 fLe,I oil r'�G ,^o d1 '((l s vl o-F O j'e- Ina v5 e Cotniletion of the followinktable may be waived by the In vector of Wires. cvf t!^ No.of Recessed Luminaires No.of Cell:Sas . No.of s� U.,, p (Paddle)Fans Transformers Total KVA - "=t 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 -ti No.of 011 Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and 1 L r Initiating Devices No.of Ranges No.of Air Cond. Total Tons k No.of Alerting Devices No.of Waste Disposers 'Heat Pump I Number Tons KW No.of Self-Contained Totals:I } I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal No.of Dryers Heating Appliances K�, Security Systems:* ❑ �� -4 No.of Water No.of Devices or Equivalent Heaters KW No.of 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: ..? 0-1:'-6- (Whenrequired by municipal policy.) Work to Start: 277-2_,0 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 En 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: 1�C 1;,,�, LIC.NO.: Signature �:--�--- LIC.NO.: (If applicable,enI r"exempt"in the license number line.) 3_3 6'sn 13 Address: J�-`j' O ,to St 44 ,a, ,2'c5 S S Bus.Tel.No.:�' ip (� Y5 71s�( *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"5"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,I hereby waive this requirement. I am the(check one ■ owner 0 owner's a t ent. Owner/Agent Signature Telephone No. PERMIT FEE:$