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HomeMy WebLinkAboutBLDE-19-002863 of Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-002863 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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 ININK OR TYPE ALL INFORMATION) Date:11/8/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform thp,ol etricat work descri low. Location(Street&Number) 198 WHITE ROCK RD ® S�W- LIJSt_ii 97V- 93 1.// Yo- Owner or Tenant CARLSON KENNETH L Telephone No. Owner's Address CARLSON CATHERINE, 198 WHITE ROCK RD,YARMOUTH PORT, MA 02675 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 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 No.of Luminaires Swimming Pool Above 0 In- o 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 Watery 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 Lie.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 ❑ owner's agent. Owner/Agent Signature �l o Telephone No. PERMIT FEE: $50.00 QE/1r C /O'/`\ 0K, Ai ' —z-" nn mmoawoah o`Massac dt , Metse OJ K " 1n=_ i Permit No. Q �Tyoartn' 'o`. io Svtc e a ,UP Occupancyand Fee Checked \--- , BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/ ] (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: 11/5/18 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)198 White Rock Rd Owner or Tenant Joseph Zaleski Telephone No. 914-319-9340 Owner's Address 198 White Rock Rd 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 El No.of Meters 1 New Service Amps / Volts Overhead El Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: GENERATOR INSTALLATION • Completion of the followingtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No. Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators 1 KVA 16 No.of Luminaires Swimming Pool Above ❑ In- ❑ No.ot 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 ❑ Connection Other No.of Dryers Heating Appliances KN, Security Systems:* No.of Devices or Equivalent No.of WaterKM, 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: $3000.00 (When required by municipal policy.) Work to Start:11/26/18 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 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. / i , i LI . 1 •17492A Licensee: Randall C.Agnew Signat '6i TA (If applicable,enter "exempt"in the license number line.) _s / 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)❑owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $