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HomeMy WebLinkAboutBlde-18-006809 Commonwealth of Official Use Only IL. 't Massachusetts Permit No. BLDE-18-006809 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:6/1/2018 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 electrical 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 0 No 0 (Check Appr late Box) Purpose of Building Utility Authorization No. Q Existing Service 60 Amps Volts Overhead 0 Undgrd 0 .o j New Service 100 Amps Volts Overhead 0 Undgrd 0 o � Number of Feeders and Ampacitye6% /�`` Location and Nature of Proposed Electrical Work: Upgrade service,install circuit for washer,dishwasher • -� ry Completion of the following table may l' " :• • . of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 74 � Transformers ?'A No.of Luminaire Outlets No.of Hot Tubs Generators 4VA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and In►tiatine 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/Alerting Devices 4. No.of Dishwashers 1 Space/Area Heating KW Local ❑ Municipal 0 Other: . Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of 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 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 r'` 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: EDWARD M LYNCH Licensee: Edward M Lynch Signature LIC.NO.: 35609 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 WIDGEON LN,WEST YARMOUTH MA 026733818 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:$200.00 OVA C- / -=) I Cho(( & 7--(A 7 Oiraix//,zoo 142.401,' N / (i —t! -.-_ •Commonwealth of///assac/see.4att6 ,_ Official Use Only it—= it = '__= cc`�� �7 Permit No. 1ff�= = . epartment o f.}ire�arvicee I=E ' Occupancy and Fee Checked — ' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] . (leave blank) APPLICATION FOR=PERMIT TO PERFORM ELE TRI AL WORK All work to be performed in accordance with the Massachusetts Electrical Code 4 , 27 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: ARMOUTH To the In sue or o fires: By this application the undersigned gives noti f his or her i ention to rform a elec cal . . , .escribed below. Location (Street&N tuber[ • ) R Owner or Tenant I E D J P4 /1 G q -le hone No. Owner's Address .Jlia ..., � 2018 Is this permit in conjun n with uilding permit? Yes No ❑ X (Ch k ropriate Box) Purpose of Building iV" e f/4 Utility Authorizatio I N UIIDING DEPARTrVIE Existing Service CO Amps d / bolts Overhead �= Undgrd❑ No.of Meters New Service (a° Amps /a(J/ ' Volts Overhead 0. Undgrd 0 No.of Meters Number of Feeders and Ampacity L align and Nat°re of Proposed trical Work: r ' • tjfr &i/q rk tor Clyagli a 40 • ompletion ohe following table may waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL$usp.(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.ot Emergency Lighting ernd. 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 Total No.of Ranges No.of Air Cond. Tons 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❑ Municipal ❑ other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of Heaters KWNo.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 El ctrical Work: (When required by municipal policy.) Work to Start: I/ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C� E AGE: Unless waived by the owner,no permit for the the licensee provides proof of liability insurance includingperformance of electrical work may issue unless undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit ipleted operation"coverage or its ssui g officbstantialgeuivalent, The CHECK ONE: INSURANCE rg BOND (Specify:)El P f perjury, I certify, under the pains and penalties o erj ry'OTHER PPlith t e at infor�'on on this a FIRM NAME: coon is true and complete LIC.NO.: Licensee:pf /� 17 C'�j SignaturelG ,k/(If applicab�, n,Wq,,c1 r � e�np�in v`n el�rce rru� er(Ir e.) t LIC.NO.: Address OO`` (// I i, �l /�� r� ©�d Bus.Tel.No.: 7 ^ 19# / J Per M.G.L. c. 147,s.9-61,security work re.uires aep Alt.Tel.No.: of Pu lie Safety"S"License: Lic. No. ,,,,,t— OWNER'S INSURANCE WAIVER: I am :ware that the Licensee does not have the. liability insurance coverage normally S required by law. By my signature below, I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent . Signature Telephone No. I PERMIT FEE: S TOWN OF YARMOUTH BUILDING DEPARTMENT p / . q 1146 Route 28, South Yarmouth, MA 02664 ';e MATTA «t 508-398-2231 ext. 1263 Fax 508-398-0836 K. Elliott, Inspector of Wires kelliott(&,varmouth.ma.us October 10,2018 Edward M. Lynch 25 Widgeon Lane West Yarmouth,MA 02673 RE: 25 Brewster Road,West Yarmouth Permit Number: BLDE-18-006809 Dear Mike; The above noted location inspection failed to pass for the reason(s) listed. Article 210-12(D) Circuit extensions Article 250-53(A)(2) Supplemental electrode required. Article 408-4(A) Circuit I/D required Please forward the required re-inspection fee of eighty dollars ($80.00) to this office and advise when the corrections have been made and when access may be gained,to the property, for the re-inspection. If you have any questions please do not hesitate to contact me. Sincerely, Town of Yarmouth, Building Department K. Elliott, Inspector of Wires