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Home My WebLink AboutBLDE-23-000739 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-000739 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] Zi APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 Zt (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:8/12/2022 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) 21 ICE HOUSE RD Owner or Tenant SWEDLUND THOMAS E Telephone No. V Owner's Address SWEDLUND CONNIE J,21 ICE HOUSE ROAD, SOUTH YARMOUTH, MA 02664PN Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. �V 0 Crt Li I 0 'Z �t 1 Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters 1 ��V" New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters ��Number of Feeders and Ampacity 'al, Location and Nature of Proposed Electrical Work: New residence. Z Completion of the following table may be waived by the Inspector of Wires. 3_\ No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total N 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. 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 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: $180.00 ---Caw blq(2,1, (16 ( (. " fsernv 4 /�q� Official Use Only „A,o f/i'/amachuzeted ► —* ,t cc77 Permit No. - 2 — C l - _ .�1-= AUG 11202 a tment o/.}ire -eruiceJ e =`C_f_=t Occupancy and Fee Checked ' .,�, t Bu1L kr�i 'REVELATION REGULATIONS [Rev. 1/07] (leave blank) A ' ' * ` • - PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 C 12.00 (PLEASE PRINT IN INK OR TYP ALL INFORMATION) Date: 1 1 Z % 1_ City or Town of: YC '-i \,,,, To the Inspector of Wires: By this application the undersigned gives notice of his or her intention perform the electrical work described below. Location(Street&Number) 1 r c.e, ,a S-Q o1' Owner or Tenant C-a 1,, r"P� ,,..)1 S U,,,, Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ar No n (Check Appropriate Box) Purpose of Building t-L✓,e.d1 C 1\4„. Utility Authorization No. Existing Service Amps / Volts Overhead n Undgrd❑ No.of Meters New Service 'Z-730 Amps / Volts Overhead Q Undgrd E No.of Meters i Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: t,v 1 v- p _i_J Jam, a 1, 1 ei 2-06 t P v?� (p 71-1,1 Completion of the following table may be waived by the Inspector of Wires.Tota No.of Recessed Luminaires No.of Ceil.-Susp. Trano KVA(Paddle)Fans No. f sformers 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 ffi No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones f Detection and No.of Switches No.of Gas Burners No.Initiating Devices No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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 KW Ballasts Data Wiring: Heaters SignsNo.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 lectri 1 Work: 'L — (When required by municipal policy.) Work to Start: ( z...e-� Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERAGE: 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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjuty, that the information on this application is true and complete. FIRM NAME: _}_�. LIC.NO.: Licensee: 4 1 1,vL,ftr Signature ____. (If applicable,enter "exempt"in Me lice a number line. LIC.NO.: 3 (� L.cS Address: 3 2 ( 0 a 3 T �q,rt„ii , 1 'A 4S f Bus.Tel.No.: 3-68 tf Y�' /sc� *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Alt. c.No..: L 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 ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ 1