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Home My WebLink AboutBLDE-19-000958 0t Commonwealth J` or /� Cof Official Use Only Massachusetts Permit Na. BLDE-19-000958 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.l/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:8/20/2018 • 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 electrt of escribed below. /� A Location(Street&Number) 34 WEST WOODS VILLAGE V a IA'kl"If' I� Owner or Tenant N6— Telephone No. Owner's Addresssonar_.. GAti j4 WEST WOODS VILLAGE,YARMOUTH PORT,MA 02675 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 ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Kitchen remodel. 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 Ab0 In- ❑ No.of Emergency Lighting grnd.ove 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local a 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 Data Wiring: Heaters Siens 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: (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: Mark A Contonio Licensee: Mark A Contonio Signature LIC.NO.: 21143 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:102 N WESTGATE RD,HARWICH MA 026451600 Mt.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 signature below,I hereby waive this requirement.I am the(check one) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$100.00 OU& 6/48 i Lk& _ tamrnomesa&of/'/aseachusetb . ai use ons _; r.-:--. -_---_ 'OR f cc77��p / prat Permit No. • _�nt�: .LJr arimrnf o f Sendai Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 1/07) (leave blank) 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 PRINTININK ORTYPE ALL INFORMATION Date: 8. 17• t 8 City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) c34/ IJESr !✓!en a . I Nosw't-Y Owner'orTenant Do GE) ttyer2- 5 Telephone No. Owner's Address 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: ICtej.i t! let5-rt-ccoDGrtlh. • • Completion of the follinvinCable may be waived by the Inspector of Wires. No.of Recessed Luminaires Na of Cell Susp.(Paddle)Fans °f Total Transformers KVq No.of Luminaire Outlets No.of Hot Tubs Generators KVA Na of Luminaires Swimming Pool Above ❑ In- No.oTkery Umnitsergency Lighting arn - No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. To No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained ' Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating ICW' Loth❑ MaWci Connectiopaln 0 °ti'? No.of Dryers Heating Appliances Security S stems:' No.of No.of Water No.of . No.of Data Wiring: or Equivalent Heaters Signs Ballasts Na of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: _ Attach additional detail if desires(or as required by the Inspector of Wires. Estimated Value of Electrical World (When required by municipal policy.) Work to Start: 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 covers in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I eemfy,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: iliire aerV th. LIC.NO.: 2"V.3-.0} Licensee: e>-e. a�ZyvieD Si ature (If applicable.enter"exempt" Tel.NO.:45.9,..5"7-.43 in the license number line.) Bus.Tel.No:Sob 776^se86' Address. j 'Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lie No. Q OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coveragerage n�ormaly OwnredAgent d by law. By my signature below,I hereby waive this requirement. T am the(check one)❑owner 0 owner's agent. al Signature Telephone No. . I PERMIT FEE: $