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Home My WebLink AboutBLDE-19-002061 , 40 Commonwealth of 1 Official Use Only I Massachusetts Permit No. BLDE-19-002061 �s� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked T (Rev.1/071 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASEPRMT IN INK OR TYPE ALL INFORMATION) Date:10/9/2018 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 etectncai work described below. Location(Street&Number) 25 BREWSTER RD Owner or Tenant KHINCHUK GREGORY Telephone No. Owner's Address KHINCHUK KSENYA, 110 STRATHMORE RD PH1,BRIGHTON,MA 02135 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) r: Purpose of Building Utility Authorization No. V 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: Install smoke detectors. 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 ❑ - ElNo.of Emergency Lighting grnd. Ingrnd. Batter,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 Initlatine 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: DetectionlAlertine 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 Data Wiring: Heaters Siena 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: JAMES B JONES Licensee: James B Jones Signature LIC.NO.: 12351 (If applicable,enter"exempt"in the license number line.) Bus.TeL No.: Address:118 MAPLE ST,HYANNIS MA 026015746 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,I hereby waive this requirement.I am the(check one) ❑ owner ❑ owner's agent. Owner/Agent Signator Telephone No. PERMIT FEE:$50.00 l`�f- lm(c0 /(6 cote . 194 Wag frat--- Commonwealth of rrlaeecawalis /Official Use Only zt c� nn C7 Permit No. t ¢Q r 2-.O Co %'4�; 2)eparimeni o`.}ire Services iter, 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: Sri cl -271& City or Town of: yar«.c,'}• To the Inspector of Wires: By this application the undersigned gives notice of his or her inter bn to perform the electrical work described below. Location(Street&Number) i . tee...51*r fit) Owner or Tenant itge...r.,!�. ' k, \1"S c.tC Telephone No. Owner's Address tra Cn6Cr.e.. • Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) , Purpose of Building iJ1pratrceL &wolk_st Utility Authorization No. Existing Service_ Am / is Overhead Und o.of Meters _____ New Service _ Amps Volts Overhead n gr No.of Meters _,__ Number of Feeders and Ampa ty Location and Nature of Proposed Electrical Work: FjoirA 5,'.cko. dQ*cc'}otrS. i• V) Completion of the followin• table maybe waived by the Inspector of Wires. Total tib No.of Recessed Luminaires No.of Cel.Sus .(Paddle)Fans No.a of KVA P Transformers KVA 2 No.of Luminaire Outlets No.of Hot Tubs Generators KVA AboveIn- No.of Emergency Lighting r No.of Luminaires Swimming Pool grad. ❑ grnd. 0 Battery Units J No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS No.of Zones No,of Switches No.of Gas Burners No.of DetectionngDevices C. and Initiating vic I l..1 No.of Ranges No.of Air Cond. Tans No.of Alerting Devices No.of Waste Disposers Heat Pump Number,I Tons__ _KW_ No.of Self-Contained p Totals: �_.....' - '.," Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW � M 0 CSyonnectionunicipal �� ur ❑ tems:* No.of Dryers Heating Appliances KW Sec No. f Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Nor Equivalent valent OTHER: Sync 2 e tn/� Attach additional detail if desired or as required by the Inspector of nitres. Estimated Value of lectrical Work: ICCa (When required by municipal policy.) Work to Start en 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 ®7 BOND ❑ OTHER ❑ (Specify:) I certify,under theffins and penalties o equry•,that the information on this application is true and complete FIRM NAME: C- e _ LIC.NO.: ( s I'g licensee: ria Q • . Signature Arnim LIC.NO.: (If applicable enter "leenrpt"in the license re lined Bus.Tel.No: Sob -1(...° 7 y Address: Sl 1/2-4r fLSS M. C Alt.Tel.No.: *Per M.G.L.c. 147,s'.57-61,security work{.quires 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. I am the(check one)0 owner 0 owner's agent. Own Bent PERMIT FEE:$ Signature Telephone No.