The URL can be used to link to this page

Home My WebLink AboutBlde-19-005785 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-005785 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:4/16/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 318&324 OLD MAIN ST Owner or Tenant SO YARMOUTH METHODIST CHURCH Telephone No. Owner's Address 324 OLD MAIN ST,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: Elevator disconnect&bathroom wiring. 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- ElNo.of Emergency Lighting rnd. 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 0 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 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 102 N WESTGATE RD, HARWICH MA 026451600 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 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: $100.00 4kYati u/,71d e—A444- ?(,l (� °c &se ►ti+- 80o Commonwealth.of///aMac tis •_ .. • Official Use Only l)1.1(7) 1-- 1;0{ 0�-5 7g5— �i= .�apa�na,�t 6[�S Permit No. 1T' crvicsl - - BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Y> {Rev. 1/07] ----- (leave blank) APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ),52 CMR 12.00 F.'`_w PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: t Id�C?' YARMOUTH 'V_' City or Town of: To the Inspector of Wires_ . 1#'this application the undersigned gives notice of his or her intention to perform the electrical work described below. ,Cc y I.4 cation (Street&Number) 3 22 Old /"t q i y $t iu El Owner or Tenant S'Ol/ty Y�rilie,t4 0ti to.1 ne-d7r ct ek-S1- Ctivreti Telephone No. ..,...._....;LQvner's Address .,......_ ._.._...,-----4s-this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑. Undgrd gr ❑ No.of Meters — New Service Amps / Volts Overhead❑ Undgrd�' ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed EIectrical Work: rieve'fe,r- + IJetrhr,o..✓J Completion of thefollawing table may be waived by the Inspector of Wires. No. of Recessed Luminaires No.of Ce�1-Susp.(Paddle)Fans No.of Total Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- No.of k!snergency Lighting Prnd. srnd. LI Battery Units No.of Receptacle Outlets No.of Ott 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. Ton No.of Alerting Devices No.of Waste Disposers• Heat Pump I Number. - Totals:I Detection/Alerting Devi H KW No.of Self-Containedices No.of Dishwashers Space/Area HealingKW' Mumicipai Local❑ Connection ❑ Omer No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent No.of Heaters KW Wiring: Signs Ballasts No.of Devices or Equivalent lia No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail cf desired or as required by the Inspector of Wires. V Estimated Value of Elec cal Work (When required by municipal policy.) Work to Start: /j2 Inspections to be requested in accordance with MEC Rule 10,and completion. upon p p etton. ��\\ INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless V the licensee provides proof of liabili insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov ge is in force,and has exhibited proof of same to the permit issuing office. D CHECK ONE: INSURANCE BOND ElOTHER El (Specify:) lS/ I certzfy, under the pains and penalties�ofperjury,that the information on this application is true and complete..� ` FIRM NAME: .A14C E/eCtr, C LIC.NO.: 2i/ /3-A Licensee: L'vnrefl erc Pr Signature 60 LIC.NO.: 5,27 `(-B (If applicable, enter "exempt"in the license number line.) Address: (02 Norty viest14ite RGl t"7 rtiCh A'M 026 s Bus.Tel.No.: S2 J *Per M.G.L. c. 147,s.57-61,securi work requires Department of Public SafetyAlt.Tel.No.: �2/ OS' "S"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n�— required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent � Owner/Agent 0 .1 Signature Telephone No. I PERMIT FEE: $ ll�C)-- 1