HomeMy WebLinkAboutE-19-2769 Commonwealth of Official Use Only
Eu,� Massachusetts Permit No. BLDE-19-002769
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
JRev.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:11/6/2018
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to pertonu the electrical work described below.
Location(Street&Number) 711 ROUTE 28
Owner or Tenant PIER 7 CONDOMINIUM TRUST Telephone No.
Owner's Address C/O R J+R A OSTELLINO TRS,711 ROUTE 28,SOUTH YARMOUTH,MA 02664-5138
Is this permit in conjunction with a building permit? Yes ❑ 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 ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Renovations to UNIT 21-B.
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 .—
Tubs Generators KVA
No.of Luminaires Swimming Pool Above 0 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
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 ❑ Municipal ❑ 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 Stens Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total IIP 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:
1 certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Aliaksei A Kuharenka
Licensee: Aliaksei A Kuharenka Signature LIC.NO.: 20711
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:564 W YARMOUTH RD,WEST YARMOUTH MA 026731456 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) 0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $7100
Commonwealth of/rtassacLueetle �Of�ficciaall,UseOnly
j' _.•.• t�ITIOtt cy� c7 C� Permit No. `2 -*7.1
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(IL Occupancy and Fee Checked
ty t � BOARD OF FIRE PREVENTION REGULATIONS -Rev. 1/07
`ay ,a 1 (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:
City or Town of: Oar +-i 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, 4 it 48 #'7/ B
Owner or Tenant it Pi er- 7 e-e ..:N i a n. -ts+-•.„.. Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box)
Purpose of Building 6 i.-s/o Utility Authorization No.
Existing Service_ Amps / Volts Overhead El Undgrd El No.of Meters
New Service _ Amps / Volts Overhead El Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: L./1.e,,,.._ 4'c,,,./ /jt y..aed'
Completion of the following table may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Toof
Transformers KVA
No.of Luminaire Outlets No.of hot Tubs Generators KVA
No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
oand
No.of Switches No.of Gas Burners No. InDetennitiatinggonDevices
No.of Ranges No.of Air Cond. Tons) No.of Alerting Devices
Ci t Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers
z Totals: � � Detection/Alerting Devices
WE Municipal
' f No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other
o cc SecuritySystems:*
aI No.of Dryers Heating Appliances KW
I+ rY No.of Devices or Equivalent
LU c w No.of Water No.of No.of Data Wiring:
V I Heaters KW Signs Ballasts No.of Dvices or Equivalent
Z No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
isu 2 o I No.of Devices or Equivalent
tie -5OTHER:
m m Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)le
Work to Start: //--to — 6' 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 ® BOND ❑ OTHER ❑ (Specify:)
I ter*, under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Coastal Light Electric LIC.NO.:20711-A
Licensee: Alex Kuharenka Signature 7-c•-- LIC.NO.:
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:508-274-9981
Address:46 Nickerson Farm Way, S. Yarmouth, MA 02664 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. I am the(check one)0 owner 0 owner's agent.
Owner/AgentPERMIT FEE: $
SignatureTelephone No.