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HomeMy WebLinkAboutBLDE-23-003746 - ` i nk Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-003746 I. 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:1/10/2023 To the Inspector of Wires: City or Town of: YARMOUTH By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 717 WILLOW ST Telephone No. Owner or Tenant PEARSON DAVID T Owner's Address PEARSON THERESA M, 3440 AUSTIN CT,ALEXANDRIA,VA 22310 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 El Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead El Undgrd 0 No.of Meters - Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for addition, HVAC, Mini-split, Elect. heaty, &upgrade service.(4 Inspections) Completion of the following table may be waived by the Inspector of ires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA ov No.of Emergency Lighting No.of Luminaires Swimming Pool Ab grnd.e ❑ In-grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting DevicesTons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices ❑ Municipal No.of Dishwashers Space/Area Heating KW Local Connection ❑ Other: Security Systems:* No.of Dryers Heating Appliances KW No.of Devices or No. NoNo.of No.of Ballasts Data Wiring: He Water KW Signs No.of Devices or Equivalent Heaters Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 LIC.NO.: 21143 Licensee: Mark A Contonio Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: o. Address: 102 N WESTGATE RD, HARWICH MA 026451600 *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 'PERMIT FEE: $200.00 I Signature Telephone No. its. z I /ill* g (ç'S' L?L )4M) •( ()c cs ,A If►-z/i3 'f—' ,,,,c, qv-1123 � '� ORr2,l-7_S Cam. G&It 6p ON Sc E RECEIVED JAN 10 2023 BUILDING s� Qa1`` yyy�jj M E N T Commonwerda /rt 4 aedachudatte By: Official Use Only ' 1 c� ��'77 Permit No, `�2- -37 4, a1 spartmsni° int.sruicsd A 1 i', f 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: /./0-,- 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) '7/7 41,iz0/,4) Si-- Owner or Tenant 25e,.-i/ i J (.9//' Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes-Er No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service / 6-' Amps /,. 4' / - Volts Overhead Und rd / g n No.of Meters New Service 2©C) Amps P / -,.. .fa_ Volts Overhea J Jnd rd / g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 4- 7/r i v,t) 4/Ew, i4V e_ ,,;5� „e• -f yY'.v: - 'idi;,i I C-ff' r�.IJ.,Fzcb2 E-6I. 3 ,n�/7 . (2P6411,9 F 5=-n�. `VI Completion of thefollowingtable my be waived by the Inspector of Wires. t� No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Transformers KVA No.of Total ... rtiNo.of Luminaire Outlets No.of Hot Tubs Generators KVA ANo,of Luminaires Swimming Pool Above ❑ in; No.of Emergency Lighting grad. grnd. ❑ Battery Units a No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and iota + Initiating Devices No.of Ranges No.of Air Cond. Tonsl No.of Alerting Devices 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 L. Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Wateearters , No.of No.of Data Wiring: Signs 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: 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: 4_ ` , G_<< c'i4- . c /ll`?—MILIC.NO.: Licensee: ' i"'- ' e,,,,, c- Signature Signature ., ---_-",.../`-..:. _.___ LIC.NO.:y 3. !.S�--8 (If applicable,enter"exempt"in the license number line.) 5'nb,7-7G e' Address: Bus.Tel.No.• *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"5"License: Alt.IT c.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. Owner/Agent Signature Telephone No. ( PERMIT FEE:$