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Home My WebLink AboutBlde-19-007047 or Commonwealth of Official Use Only It Massachusetts Permit No. BLDE-19-007047 ik 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:6/13/2019 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. j, Location(Street&Number) 12 OAK GLEN VILLAGE CO S. Rj oK. i 3 ea Owner or Tenant FROUDE DONALD E Telephone No. Owner's Address P 0 BOX 2048, DENNIS, MA 02638 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: Install 4 ceiling fans, replace bath room lights, chandelier&wire air cond. system. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 4 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. rnd. 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. 1 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 ❑ 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 Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: INo.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) ❑ owner 0 owner's agent. Owner/Agent - Signature Telephone No. PERMIT FEE:$75.00 (aL> 4141 l t . (u ctilolrgf • 1 _ _ Commonwealth off//lassac�ucsalfs Official Use Only _ 4'-: c� c� n sil= s .2.parEmani o f.1 irs..arviw Permit No. 1c_ _• 1 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev. 1/07] (leave blank) O ' - i` APPLICATION FOR:PERMIT TO PERFORM ELECTRICALW l9 All work to be performed in accordance with the Massachusetts Electrical Code WORK ORK .,/) - (MEC),527 CMR 12.D0 3 c\ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 6-/a'!9 yam, City or Town of: YARMOUTH "��,,� �z To the Inspector of Wires: B this application the prrdersigned gives notice of his or her intention to perform the electrical work described below. -1 , L,cation(Street&Number) a OtF t . e ,V — ( C l .. It'2a(��i?f-Pow 1 Owner or Tenant Aid)c,L :Solt/ v__._.._ _ Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undg rd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: A pp kt ' ,`L(' 6 51,0 S Or, (-4-) ,e He- 6417 ✓et41?Ty %'i 5 +- Ct1-.+70 Dom: €e- )i✓e 6 Atersis, Completion of the follawin table may be waived by the Inspector of Wires. No. of Recessed Luminaires No.of Cea1.-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 • Qrnd. arnd. ❑ 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. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Tons f KW No.of Self-Contained Totals: f Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Mcipal Connectiuni on ❑ Other ... No.of Dryers Heating Appliances KW Security Systems:* W No.of Water No.of No.of Devices or Equivalent Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: (n 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.) VWork to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,ao 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 0 undersigned certifies that such covers force,and has exhibited proof of same to the permit issuing office. "' CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) e I certify, under the pains and penalties of perjury,that the information on this application is true and complete '. FIRM NAME: 4-E Ee 2/c._ fl Licensee: ,�„�,�, LIC.NO.: +Qrl z�,1 IgAri.tc Signature -°''- LIC.NO.: /3:V95-8 ` (If applicable,enter"esempt"in the license number line.) Bus.Tel.No.:52 e3 776 g Address. J `Per M.G.L. c. 147,s.57-61,securi rc Alt TeL No.: ty work quires Department of Public Safety"S"License: Lic.No. — OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement I am the(check one)❑owner ❑owner's agent. - Owner/Agent I Signature Telephone No. LPER1l1IT FEE: $ 7S—