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HomeMy WebLinkAboutBLDE-18-006250 Of Commonwealth of. OfleialUseOnly Massachusetts Permit No. BLDE-18-006250 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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 INFORALITION) Date:5/7/2018 City or Town of: YARMOUTH To the Inspector of Wirer By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 51 ARROWHEAD DR Owner or Tenant KOERBER KAREN L(LIFE EST) Telephone No. Owner's Address CRISAFULLI THERESA(LIFE EST),51 ARROWHEAD DR,YARMOUTH PORT, MA 02675-2402 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install generator 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 1 KVA 11 No.of Luminaires Swimming Pool Above ❑ 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 Beat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwasher Space/Area Heating KW Local 0 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 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 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: Randall C Agnew Licensee: Randall C Agnew Signature LIC.NO.: 17492 (Ifapplmable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:381 OLD FALMOUTH RD, MARSTONS MILLS MA 026481555 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:$50.00 4331c3(<g oft 1 .� • J Commoaweat o`rr/msate('fa O icial Uim Only L —v ; €t c7 nn Permit No. E, Aiirl rcy�epa.La.at of Jiro Serviced kirOccupancy and Fee Checked `."= r 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 INFORMATIONV) Date:5/4/18 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)51 Arrowhead Drive Owner or Tenant Karen Koerber Telephone No. 617-645-1010 Owner's Address 51 Arrowhead Drive Is this permit in conjunction with a building permit? Yes ❑ No © (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps 120 /240 Volts Overhead® Undgrd❑ No.of Meters 1 New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: GENERATOR INSTALLATION i Completion of the following table may be waived by the Inspector of Wires. oTotal No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tof Traa onKVAsformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators 1 KVA 11 No.of Luminaires Swimming Pool Above ❑ In- 0 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 1Vo.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons Heat Pump Number. Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Ileating KW Local❑ Municipal ❑ Other ( Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent Y No.of Water No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.lfydromassage 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: $3000.00 (When required by municipal policy.) Work to Start:7/17/18 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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties ofperjury,that the informa 'in in this application is true and complete. FIRM NAME: RCA Electrical Contractors Inc. a 7.// / / LIC.NO.:17492A I r or in Licensee: Randall C.Agnew Signature a a (If applicable,enter "exempt"in the license number line.) Bus.Tel.No..508-428-0449 Address: 381 Old Falmouth Road, Unit 13, Marstons Mills, MA 02648 Alt.Tel.No.:508-648-6766 *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)❑owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $