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Home My WebLink AboutE-19-213 or Commonwealth of Official Use Only t®, Massachusetts Permit No. BLDE-19-000213 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked , IRev.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:7/11/2018 - City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work describe below. Location(Street&Number) 86 LOOKOUT RD rli-s�'�P-,JJ (At Owner or Tenant Telephone Telephone No. Owner's Address - _. _ - '.• _ _ �.e��:e Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Boa) 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: 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 22 No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting / grnd. grnd. Batters,Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches i 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 ❑ 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 sten: 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 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:381 OLD FALMOUTH RD,MARSTONS MILLS MA 026481555 Mt.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. r Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 icv E.. g! 45 1 g Kg-- �81 14 't g co(cg (,e -�, Commonuraatth o`Madiackentb Official Use Only ff . f 'Z_ 'R8-! c� cc77 nn Permit No. • c =111E- T spartn.nl o`Jin Services • -=',fr— $ 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 INFORMATION) Date:7/6/18 City or Town of: Yarmouthport 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)86 Lookout Rd Owner or Tenant Jerry Wilson Telephone No. 614-537-8757 Owner's Address 86 Lookout Rd Is this permit in conjunction with a building permit? Yes ❑ No ❑X (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 200 Amps 120 /240 Volts Overhead IN 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 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 Transformers KVA KVA No.of Luminaire Outlets No.of Hot Tubs Generators 1 KVA 22 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 Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of WaterKW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total IIP 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: $3000.00 (When required by municipal policy.) Work to Start:10/11/18 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. ry CHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: RCA Electrical Contractors Inc. ,-) ' LIC.NO.:17492A (..,�. 4 Licensee: Randall C.Agnew Signature r/ j LIC.NO.: (Ifapplicable,enter"exempt"in the license number line.) ru • ]jus...Tcl.No.•508-428-0449 Address: 381 Old Falmouth Road, Unit 13, Marstons Mills, MA 02648 - :''Alt.Tel.No.:508-648-6766 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/AgentPERMIT FEE:$ SignatureturaTelephone No.