The URL can be used to link to this page

Home My WebLink AboutBLDE-20-003243 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-003243 . 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:12/6/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perto the described below. Location(Street&Number) 91 BLUE ROCK RD U {�'-0�� Owner or Tenant F Telephone No. Owner's Address 91 BLUE ROCK ROAD, 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 100 Amps Volts Overhead 0 Undgrd ❑ No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service.(TRENCH INSPECTION) 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 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 ❑ 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.Bat h j(J signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. e. Owner/Agent Signature Telephone No. PERMIT LSE: $250.00 Ogg Th E VDUtTg, 1b 146 a1 L/ Erg XI`I "l 7i l -- _ epartmenf oii. lire Services Permit No. -- - BOARD OF FIRE PREVENTION REGULATIONS , •Oc .and Fee Checked :. 1/073 4 9s APPLICA cave blank TION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the mitts Electrical Code(MEC),527 OAR 12.00 • (PLEASE PRINT IN INK OR TYPE ALL INFORMATIOI 9 Date: iN°5' 1 P ,�( � City or Town of: YARMOUTH To the Inspector of Wires: i. J By this application the undersigned gives notice of his or her intention to perform the electrical work described below. `bt, NLocation(Street&Number) 9'/ 8 i-,�c/ � c )e\ ,,� VVV Owner.or Tenant S�•^1 epor, i Forte `�UiJ Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes ❑ No Check Appropriate ppropriate Box) Coa-- Purpose of Building Utility Authorization No. 02 36 6 sa 7 act,i,Existing Service I 1 Amps lac)/ i CVolts Overhead,a- UaciR-d❑ No.of Meters � New Service C) Amps /2c) / ,tyo Volts Overhead ElUndgr J Number of Feeders and Ampacity -CJ No,of Meters Location and Nature of Proposed Electrical Work:-1 P4 _A.,, tf e tc�/L) AkIC Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-S (Paddle)Fans No.of Total �• Transformers KVA No.of Luminaire Outlets No.of Hot Tubs - Generators KVA No.of Luminaires Swimming Pool Above ❑ la- No.of Emergency Lighting grad. ar•nd_ � Batter'Units No.of Receptacle Outlets No.of OR Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of D ection and • Initiating Devices 1.. No.of Ranges Total • Na of Air Cond. Tom No.of Alerting Devices w No.of Waste Disposers Heat Pump I Number 'Tons 1KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local❑ Municipal Connection 0 Other i No.of Dryers Heating Appliances KW Security Systems:* Na.of Water No.of No.of Devices or Equivalent Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent 1 ` No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - O 1'itER: No.of Devices or Equivalent Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work Work to Start: (When required by municipal_policy.) �1 Inspections to be requested in accordance with MEC Rule 10,and upon completion. v INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless Q the licensee provides proof of liability i including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such covera ' in force,and has exhibited proof of same to the permit issuing office. p CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certify, under the pains penalties o u i FIRM NAME:,/ fp�'��the information on this application is true and complete V /""` G ��: / LIC.NO.: _;•.4 Licensee: c.) Signature S' (If applicable,enter"exempt"in the license number line.) LIC.NO.: / 34�J i Address: Bus.Tel.No.: j `Per M.G.L. c. 147,s.57-6 l,security work requires Department of Public Safe AIL TeL No.: ty"S"License: Lic.No. ;z- OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally ally required by law. By my signature below,I hereby waive this requirement I am the(check one)Elowner Elowner's agent, Owner/Agent aC 5 L� i Signature