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HomeMy WebLinkAboutBLDE-18-006513 Commonwealth of Official Use Only 4,40 Massachusetts Permit No. BLDE-18-006513 - - BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked _ JRev.l/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:5/21/2018 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) 31 IROQUOIS BLVD Owner or Tenant GEHLY ALBERT T Telephone No. Owner's Address GEHLY GAIL,31 IROQUOIS BLVD,WEST YARMOUTH,MA 02673 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. _ Existing Service Amps Volts Overhead 0 Undgrd ❑ 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: 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 9 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 Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* _ No.of Devices or Equivalent No.of Water K V 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 ❑ (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 (Ifapplicable,enter"exempt"tn 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:lam 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 9[w<<8 cce-- eL& (i). f2-1 (re ceRY Commonwealth. Vy7 Official Use Only o`///meacsifs y6 �� - 513 t cc�� PIPS Permit No. hepartnunt o`Ji.r�rrvitu �- If=a Occupancy and Fee Checked `n 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: 5/15/18 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)31 Iroquois Blvd Owner or Tenant Gail Gehly Telephone No. 802-376-9528 Owner's Address 31 Iroquois Blvd. 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[I 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 v 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 g 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. Tot No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained a Totals: Detection/Alerting Devices .. No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection 4 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 Wirin No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: $3000.00 (When required by municipal policy.) Work to Start:8/9/18 inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The k, undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND ❑ OTHER 0 (Specify:) „ I certify,under the pains and penalties of perjury,that the inform�a�tiarf�e this application is true and complete. FIRM NAME: RCA Electrical Contractors Inc. C� a rt LiC.NO.:17492A Licensee: Randall C.Agnew Signature ((((�((((�f `. /7 IC.N .: (Ifapplicable,enter "exempt"in the license number line.) mus.Tel.No.:508-428-0449 Address: 381 Old Falmouth Road, Unit 13, Marstons Mills, MA 02648 Alt.Tel.No.:508-648-6766 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,i hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent PERMIT FEE:$ Signaturetura Telephone No.