The URL can be used to link to this page

Home My WebLink AboutBLDE-22-000785 PO Official Use Only Z Commonwealth of /E Massachusetts Permit No. BLDE-22-000785 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:8/10/2021 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 descryJ6 ee�d below. / Location(Street&Number) 10&10A RUBY ST Lei/ (l0' '2PT Owner or Tenant Anar Abasov Telephone No. Owner's Address 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: Kitchen&bathroom wiring 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 grn . 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. To No.of Alerting Devices 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 Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens 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:) certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 age . Owner/Agent Signature Telephone No. l - IfD/14 124 PERMIT FEE: $250.00 'A iAU. tAU t TOBtP a spate u4> u g (? emu e.E (s4,14.6) - tt-( 8i3P77-1 - 14 Commonwsa&01///aedachuddle Official Use Only ',. ,/ cc77 Permit No.' 2spartmenl ol1. ire Serviced / _ 1; J. 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 INFORMATIQM Date: 81 9'/0 / \j City or Town of: YARMOUTH To the Inspector of Wires: By this application the +(undersign)gives notice of his or her intention'✓/to perform the electrical work_described below. Location(Street&Number) Ci LI A r S j W E c T V//a M K o ( H Nk Owner or Tenant A NAg ms A so_..17 1 _Z Telephone No. 67 (� /0 t j Ay {2 01 Owner's Address 10 U t I` c T i'V y, S T r A P H a u T f� Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) ' ••• Purpose of Building Utility Authorization No. Y Existing Service Amps / Volts Overhead❑ Undgrd❑ 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: C revri6ti r ttr�ttpm I,. i la 1Iva Comaletioaofrye foJosv:rgiabbie rav be waived by the Inspector of Wires. I Total 11.1 o.of Recessed Lumin*es 'No.of Ceil.-Snap.(Paddle)Fans No KVA _Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA IQ w No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting grnd. ❑ grnd. ❑ Battery Units '4" 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 c. t I? No.of Ranges No.of Air Cond. Tons No.of Alerting Devices Na of Waste DisposersHeat Pump Number Tons 1 Tro.of Self-Contained Totals: l" Detection/AlertingDevices No.of Dishwashers Space/Area HeatingKW Municipal p L0�❑ Cyyonnection 0 Other No.of Dryers Heating Appliances KW SecurityNf Devices or Equivalent No.of Water No.of No.of HeatersKW Signs Ballasts Data Wiring: 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: SO Q t (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: 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: LIC.NO.: Licensee: Signature LIC.NO.: (Ifapplicable,enter"exempt"in the license number line.) Bus.TeL No.: Address: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lic.No.. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By silure below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent � Signature . Telephone No.C( ' 6 r'0 2 tt.J PERMIT FEE:$ 2 SO 0 I z'fgq poi eQ kp h e-Iio/2-I ,en?c .