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Home My WebLink AboutBLDE-18-003875 ° '' '� Commonwealth of OfrcialUse Only • fiz\ Massachusetts Permit No. BLDE-18-003875 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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:1/8/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives no ice o is or her m en ion per orm yrte ec is work desc ' ed below. Location(Street&Number) 14 SEA GULL RD f C J P AC.WO Owner or Tenant VELICHANSKY LEONID Telephone No. Owner's Address VELICHANSKY L&GERSLT I&SIDORSKAYA, 13 KNOLLWOOD RD, MEDFIELD, �st052 Is this permit in conjunction with a building permit? Yes 0 No 0 (C k . i .. - :ox) Purpose of Building Utility Authorization N . _ Existing Service Amps Volts Overhead 0 Undgrd 0 • w New Service Amps Volts Overhead 0 Undgrd 0 e e ,a41Number of Feeders and Ampacity ��//��//// rdrirtis, Location and Nature of Proposed Electrical Work: Wring for air handlers and condensers. Jr' 0 Completion of the following table ajQ ivea'srY'�' . ctor• of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of otal Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ Io- I: 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. 2 Ton Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons 1 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 Eauivalent No.of Water - - KH, No.of No.of Data Wiring: Heaters Sinns Ballasts ' No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total LIP Telecommunications Wiring: No.of Devices or Eauivalent 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: Daniel J Peckham Licensee: Daniel J Peckham Signature LIC.NO.: 26830 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:87 AUDREYS LN, MARSTONS MLS MA 026481629 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,)hereby waive this requirement.I am the(check one) ❑ owner 0 owners agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 II i9�2. l-ornn»nrw�of rr/eseacfuceefts OEiciei Use Only 1�W Permit No. =711_ 25oc rncni of.giro.�wiced .- Occupmay and Fee Checked BOARD OF RRE PREVENTION REGULATIONS • ___ I/07) neve blank)0 - APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK AU work to be performed in accordance with the lvfr_csacbuscns Electrical Code(MEC),5'7 C1411.1200 (PLEASEPRINTININK ORTYPE A_LLLVFORM4TIDI9 Date: / ter City or Town of: YARMOUTH To the Inspr of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. • Location(Street&Number) / 9 5-c ce_ sa,,r(.I Owner•orTenant 4j.. . I"0 P-6 Vu Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Btulaing Utility Authorization No. ,Q, Existing Service Amps / Volts Overhead Q Undgrd❑ . No.of Meters _ "J New Service Amps / Volts Overhead❑ Undgrd ❑ Nd.of Meters - Number of Feeders and Ampacity I- ! Location and Nato. of Proposed Electrical Work - n —..I • n Lett.✓ n e-ce-• J�r AL Inc._.gje. CS '! idle_ ulJ no i r.tLn ->OttL7 ^j N Completion of the following table may be waived by the Inspector of Wirer. ¢ No.of Recessed L¢min:aresINa of Cer1�S of Total o0 tsp.(Padre)Fags INC.(Transformers I{VA Vt� ii No. of Luminaire Outlet INo.of Hot Tubs (Generators • EVA • L . Q 't), No.of Luminaires (Swimming Pool Above ln- No.or nmergeacy La�hrmg LJJ —) �� °rad. mid. IEatterpUnitt ��no ¢ No.of Receptacle OntL-ts No.of Oil Burners 'F]itE ALARA'IS INo,of Zones • No.of Switches No.of Gas Ea "No.• of Detection and Initiating Devices No.of Ranges INo.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers I Pleat Primp I Number Tons KW No.of Sett Contained Totak: Detee on/Alerdno Devices No.of Dishwashers • Space/Area Heating KW LocalMErcipal ❑Cormectian ❑ er No.of Dryers (Heating Appliances KW Security Systems:' No.of Devices or Equivalent No.of Water INo.of No. of DaWt ta rm Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs INo:of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent . O l ldr,R 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: INSURANCXBOND 0 OTHER 0 (Specify.) I ter*, render the pains and penalties ofpcf w3,that the information on this application is true and complete FIRM NAME: LIC.NO.: • Licensee:42, •,.i „1-�✓�ca. . SignatureC�/�(�1L. LIC.NO: 3�� (Jfappliearble,enter "axe pt"in the license number line.) Bus.Tel.No.L_ Address ? A- .e�jc L„•_ Alazcce,t� p,":1.1, Alt Tel.No.:Svs!7>/sgp,S- J Per M.G.L.e. 147,s.5745 security work requires Department of Public Safety"S"License: Lic.No. — OWNER'S INSURANCE WAIVER I am aware that the Licensee does nor 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 t Owner/Agent Signature ho Telepne No. I PERMIT FEE: $ 1