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Home My WebLink AboutBLDE-23-001904 co ..y Commonwealth of Official Use Only .�, Massachusetts Permit No. BLDE-23-001904 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:10/11/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pe the electrical w k described below. Location(Street&Number) 20 CENTERBOARD LN ()AV J) jll4f- Owner or Tenant �lephone No. Owner's Address , 20 CENTERBOARD LN, SOUTH YARMOUTH, MA 02664-1004 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: Remodel kitchen 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/Alertine 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 Ballasts Data Wiring: Heaters Sins 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 ❑ (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 ,„/,, 6-„t, 4E_ aw 6,,,L2)AAJAY) h�t�� . ' * i I _ _ u /l €fnai 1 y/K 1;Gen it t-Mid-ra/4 RECEIVED /�� yy�]A / �_ •._ ..._. awaallh of/r/mdaehadciia Official Use Only 1. 11 a?.C T 112022 Permit No. 23 "l„1 O .O 14 Id EJiro Serviced L. .t Occupancy and Fee Checked k. 1 0,N(BOARD(1. r (leave PREVENTION REGULATIONS -Rev.1/07) blank) __._.. .._ i\ APPLICATION F R PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in aces dance with the Massachusetts Electrical Code(MEC),527 CMR[2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIOM Date: IC /� �� City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention m perform the electrical work described below. 'i Location(Street&Number) 2 a C'E,27TE-72—6d,f z p L/Fi✓E Owner or Tenant iljl/Po/7/ Telephone No. Owner's Address // J Is this permit In conjunction with a building permit? Yes. No ❑ (Check Appropriate Box) ▪ Purpose of Building Utility Authorization No. l_.• Existing Service /Od Amps /2d/ i fd Volts Overhead s U dgrd❑ No.of Meters /:J New Service ?O(J Amps /70' /?g0 Volts Overhead-❑ dgrd❑ No.of Meters / Number of Feeders and Ampaclty Location and Nature of Proposed Electrical Work: 14-7edz'sd /Zc rL„oyy Completion of thefollowingtable m be waived by the Inspector of Wires. U.. No.of Recessed Luminaires No.of Cell:Snap.(Paddle)Fans No.of 7 oral Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA d- No.of Luminaires • Swimming Pool Above ❑ In. ❑ No.of Emergency Lighting ¢rod. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No. GasBurnersNo.of Detection and t _ ofInitiating Devices l`l No.of Ranges No.of Air Conde Tonal No.of Alerting Devices No.of Waste Disposers s Heat Pump Number Tons KW No.of Self-Contained Totals - ""`- .. . . Detection/Alerting Devices 1 No.of Dishwashers Space/Area Heating KW Local❑Monunidpa O Other C nection No.of Dryers Heating Appliances KEY Security Systems:* No.of Devices or Equivalent No.of Water KW No.of Na.of Data Wiring: Heaters Sins Ballasts g 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 b wner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability in ce including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such cov a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURAN BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: )lf7-c :,ram S/YL'. LIC.NO.:?//1` 71` Licensee: /1.4'tev G>s,70':r'"v Signature_ LIC.NO.:/L '/3 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No..Sod-776-5189 Address: Alt.TeL No.: Per M.G.L.c.147,s.57-61,security work requires 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 required by law. By my signature below,I hereby waive this requirement. lam the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ r.� inc- d Lr 431CGI - No> PeUralE4