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Home My WebLink AboutBLDE-22-002312 Commonwealth of official Use Only '1. Permit No. BLDE-22-002312 Massachusetts '' 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:10/22/2021 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 described below. Location(Street&Number) 113 CROWELL RD Owner or Tenant SHMUYLOVICH IRINA Telephone No. Owner's Address 38 DUNBAR RD,TORONTO, ON M4W 2X6 Is this permit in conjunction with a building permit? Yes 0 No 0 (Chec Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd Meters New Service Amps Volts Overhead 0 Undgrd "ieNh, o ers Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for mini split system. Q 47P Completion of the following tabled A' i Spector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers 46 KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. l rnd. 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. 1 Tn Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertinc 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 _ Signs - ____ No.of Devices or Eauivalent 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: SEAN C ROGAN Licensee: Sean C Rogan Signature LIC.NO.: 20141 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 MELIX AVE, PLYMOUTH MA 023601280 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 agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 RECEIVED i13�U3 will . WIGI( /CthLe rOCT 212021 GOO l( Ccc,11 BUILDING DE PAR !m Commonwealth oil rr/meachaietta Official Use Only ar------ --- ZZ-Z_3\Z I :>r�a1 �7 core. Permit No. ,..;�,,,XI apartment of ies Je ices "�.l] ,.4 Occupancy and Fee Checked �t� 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: joj,Z,//Zi Cr City or Town of: YARMOUTH To the Inspector of Wires: 8 By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) //,3 e./,wG// /bs..,,/j 4 Owner or Tenant yvr y Sh r,�y/,,fc, Telephone No. Owner's Address c-s . � Is this permit In conjunction b witha building permit? Yes ❑ No (V (Check Appropriate Box) r-i Purpose of Building /1.4414*j Utility Authorization No. t--j Existing Service Amps / Volts Overhead❑ Undgrd No.of Meters ' ❑New Service Amps / Volts Overhead ❑ Undgrd g ❑ No.of Meters Number of Feeders and Ampacity IA Location and Nature of Proposed Electrical Work: /N/^! Sp/Ir Srsr-Lir Completion of the followingtable may be waived by the lttspector of[Mires. '!\ No.of Recessed LuminairesNo.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA c. No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. 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. Tool No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW _ No.oTSelf-Contained Totals: ... . ..".."... Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local Municipal ❑Connection ❑Other No.of Dryers Heating Appliances KW Security Systems:+ No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Aydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach addition(detail if desired,or as required by the Inspector of{Mires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 45/Zi/s4/ 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 cove is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Q'BOND 0 OTHER 0 (Specify:) I certify,under the pains and�genalties of perjury,that the information ens this application is true and complete. FIRM NAME: SC Ky�4`/uj7tAr J7 LIC.NO.:A2-%2f/ c- Licensee: 1 G/&04./ Signature4 LIC.NO.:"7.6736") (If applicable.enter"exempt"'in//he lice/se number line.) • Si$6 /� Address: /l ei::i 44--, er line.) (/ip But.Tel.No.: S' Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does trot have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's a ent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ ,51)1