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Home My WebLink AboutBLDE-22-001120 Commonwealth of Official Use Only " � Massachusetts Permit No. BLDE-22-001120 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:8/27/2021 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) 85 STARBUCK LN Owner or Tenant GARULAY ANDREW R Telephone No. Owner's Address GARULAY JANET E, 85 STARBUCK LN,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 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: Convert garage into room. 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 No.of Waste Disposers Heat Pump Number Tons f KW No.of Self-Contained Totals: Detection/Alerting 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 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 ❑ 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 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 Nil 4-- ctli (-24 (1123-04m) 60 P 9./ 4/2.4 ( . r--t i)6).L catt 7212 - ,: - RECEIVED i [ AUG 2 f Mt, CyyOfficial Use.._. .. ,,�, 0 c� BUILDING CAE ` 'T r(JP /e7, n Permit No. =1i1---t` .0 e r :M a adman#of ua Serviced `' `''} Occupancy and Fee Checked (� ' .�,,' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 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 PRINT IN INK OR TYPE ALL INFORMATION) Date: j 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. V Location(Street&Number) 8S � 8J1L.C LA) . v Owner or Tenant ,4.4)L 24-: J CA-2 v L V Owner's Address Telephone No. v Is this permit in conjunction with a building permit? yeS, 'v Purpose of Building N0 ❑ (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters pi 2 New Service Amps / Volts Overhead Number of Feeders and Ampacity ❑ Undgrd ❑ No.of Meters 1 Location and Nature of Proposed Electrical Work: nor � .��T` ��c: �c 2 A VI i°v Com letion o the ollowin table m be waived b the Ins actor o Wires. th No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans °•° ota 1'1 No.of Luminaire Outlets Transformers KVA '.^\ No.of Hot Tubs Generators KVA ,. No.of Luminaires Swimming Pool rnd.e ❑ n- °•eo Units mergency g ng nd. Bette Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No,of Switches No.of Gas Burners o.o etec on an 4 r No.of Ranges Initiatin Devices No.of Air Cond. ota Tons No.of Alerting Devices No,of Waste Disposers eat ump um er ons Totals: Detection/Alertin ta Devices No.of Dishwashers Space/Area Heating KW Local❑ un c l No.of Dryers Heating Appliances KW ecu ty Cyy stems: ❑ �� o.o a er ° o No.of Devices or Equivalent Heaters ' ° ° Data Wiring: Si ns Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommun ca ons r g OTHER: No.of Devices or E uivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: (men required by municipal policy.) d in INSURANCE COVERAGE: Unless Inspwaived byections to the ownere ,no permit for the performancece with MEC lof ee lectrical tra al work completion. the licensee provides proof of liability insu includingmay issue unless undersigned certifies that such cove `completed operation"coverage or its substantial equivalent. The s in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER I certify,under the pains a penalties o 0 (Specify:) FIRM NAME. rperlury,that the information on this application is true and complete. Licensee: �/ibt .,/i d LIC.NO.: 09113—`4 Signature LIC.NO.: J (If applicable,enter exempt in the license number line.) Bus.Tel.No.: S Address: SS *Per M.G.L.IN a 147,s.57-61,security work requires De `5 e Lie.No. OWNER'S NSURANCE WAIVER: ! Department of Public Safety"S"License: Alt.Tel.No.: WNed by l . By y m si am aware that the Licensee does not have the liability insurance overage ormal�y Owner/Agentrequir gnature below,I hereby waive this requirement. I am the(check one Signature • owner ■ owner's a.ent. Telephone No. PERMIT FEE:$ 7