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Home My WebLink AboutBLDE-56-000861 -ktptCommonwealth of Official Use Only Massachusetts Permit No. BLDE-23-000861 BOARD OF 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:8/18/2022 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) 1 SEASIDE VILLAGE RD Owner or Tenant MELARAGNI DAVID C Telephone No. Owner's Address 2 DIANA DR,WOBURN, MA 01801 Is this permit in conjunction with a building permit? Yes ❑ 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 bathroom 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 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 ❑ 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 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 •=2 )‘„yrati f3(72)-2, /7.,, f, t 2/2.4.2'/ " _ _ _ ' RECEIVED LAUG 17 2022 14 /� /A�' �n B I� C mmonwealk rrladeache child Official Use Only BOLDING NT JinJ Y�3—D1 r-- !i [,- , c� Permit No„_ ; 2epartmeni of Serviced ...f I„-.a Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in aroardmce with the Massachusetts Electrical Code(M ,527 CMR 12.00 ry (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: D� 7/- Z City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives noeofhis or her intention to perform the electrical work described below. Location(Street&Number) 1 g- A SA Le-' V t I 141.7 t, RA. Owner or Tenant De-vra Alu,IGret1ni - Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes Q No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead E 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: re IN). 1 w I (.„1 t\V;, q V 2 U N l--� Y ct Completion of the followin&lable may be waived by the Ingector of Wires. U, No.of Recessed Luminaires No.of Cell-Snap.(Paddle)Fans No.of Total Transformers KVA '=a No.of Luminaire Outlets No.of Hot Tubs Generators KVA r, 4 No.of LuminairesSwimming Pool Above ❑ in- No.of Emergency Lighting — arod. grad. ❑ Battery Units `' No.of Receptacle Outlets No.of OII Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 'No.of Detection and Initiating Devices III No.of Ranges No.o1 Alr Cond. Tons No.of Alerting Devices No.of Waste DisposersMeat Pump Number.Tons.,.,,_KW No.of Self-Contained Totals: ". Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local El Connection El , C No.of Dryers Heating Appliances KW Sec uri No o Systems:* Devices or Equivalent No.of Water , No.of No.of Data Wirin Heaters 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: /5-00. (When required by municipal policy) Work to Start: g//7. 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[ BOND ❑ OTHER❑ (Specify:) I certify,antler the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME:,t LIC.NO.: Licensee: /v t r it 1,r„R, Signature /ice 2._____ LIC.NO.: ,S—.36 2-C> 3 (If applicable.enter"exempt"in the 1eM1T mbar fine.)e.l :)"" � Bus.Tel.No. SO 2T CA'S-7 15"t f Address: '7 z f V-Crc "Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Te.el. 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 agent. Owner/Agent Signature Telephone No, I PERMIT FEE:$