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HomeMy WebLinkAboutBLDE-18-007019 Commonwealth of Official Use Only i a Massachusetts Permit No. BLDE-18-007019 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked f Rev.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:6/11/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm elecumal . ed below. , a pip Location(Street&Number) 72 BROOKHILL LN ai , c�(G JV I.Cii-A. Owner or Tenant TRS Telephone No. Owner's Address A" • . . . a _ . :- :. - ..• ,MA 02664 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 ❑ Undgrd 0 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 16- _ _ 1 No.of Luminaire Outlets No.of Hot Tubs Generators 1 KVA No.of Luminaires Swimming Pool Above ❑ I - ElNo.of Emergency Lighting gird. gird. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.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 Tont No.of Waste Disposers Heat Pump Number , Tons KW No.of Self-Contained Totals: Detectlon/Alerting 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 Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Sians 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 (If applicable,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 ,�i\ ._,C.��coEJ 8 �r(�j J' v l.ommonwsant of///as,acLa.(fh Official Use Only s Mgt=tt 71iy cry7, �7 CC�� Permit No. rsa .Ue rinunt o ,lira Serviate E t Occupancy:, �,�(-�,' � and Fee Checked l 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:6/6/2018 City or Town of: Yarmouth To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number)72 Brookhill Lane Owner or Tenant Joe Brouillard Telephone No. 508-418-8877 Owner's Address 72 Brookhill Lane,W.Yarmouth 02673 Is this permit in conjunction with a building permit? Yes ❑ No © (Check Appropriate Box) Purpose of Building single family Utility Authorization No. Existing Service 200 Amps .120 /240 Volts Overhead IN Undgrd El 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 Completion of the followingytable may be waived by the Inspector of Wires. Totallo.of Recessed Luminaires No.of Ceil: TranoKVA Susp.(Paddle)Fans Toa f sformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators 1 KVA 18 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 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump I Number I 1 Tons I KW. No.of Self-Contained Totals: r 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 V AterKW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent — No. Hydromassage Bathtubs No.of Motors Total HP t elecom No.off DDevicevic tions Winng: I es or Equivalent OTHER: Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: $3000.00 (When required by municipal policy.) Work to Start:8/9/2018 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:icensee 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the inf ation on this application is true and complete. FIRM NAME: RCA Electrical Contractors Inc. LIC.NO.:17492A Licensee: Randall C.Agnew Sig a (ifapplica1'le,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"5"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/Agent Signature Telephone No. PERMIT FEE: $