HomeMy WebLinkAboutBLDE-22-000318 �• 0..40 Commonwealth of Official Use Only
1 i ` Ort Massachusetts Permit No. BLDE-22-000318
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.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 INFORMATION) Date:7/19/2021
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) 164 DRIFTWOOD LN
Owner or Tenant FINE TOBE TRS Telephone No.
Owner's Address FINE JAMES, PO BOX 962, DENNIS, MA 02638
Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service 200 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: Generator Installation w/25'trench
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 24
No.of Luminaires Swimming Poolg bovernd. ❑ gr nd. ❑ No.of Emergency Lighting
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
Ton
No.of Waste Disposers Heat Pump I Number I Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal
Connection 0 Other:
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of Devices or Equivalent
KW No.of No.of Ballasts Data Wiring:
Heaters Signs 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: 09/20/2021 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 S eci
I certify,under the pains andpenalties o (Specify:)
fperjury,that the information on this application is true and complete.
FIRM NAME: RANDALL C AGNEW
Licensee: Randall C Agnew Signature
LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 17492
Address:381 OLD FALMOUTH RD, MARSTONS MILLS MA 026481555 Bus.lt. Tel.No.:::
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.
OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But my
signature below,I hereby waive this requirement.I am the(check one)) 0 owner ❑ owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE:$75.00
I
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Official Use Only
>< Massachusetts Permit No.
BLDE-21-001057
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
Rev.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 INFORMATION)
City or Town of: YARMOUTH Date:To Inspec020
By this application the undersigned gives no ice o is orher m en ion o pe orm e e ec ica work described below.r of Wires:
Location(Street&Number) 170 DRIFTWOOD LN
Owner or Tenant FINE TOBE L TRS
Owner's Address FINE JAMES BOX 962, DENNIS, MA 02638 Telephone No.
Is this permit in conjunction with a building permit?
Purpose of Building Yes 0 No 0 (Check Appropriate Box)
ps Utility Authorization No.
Existing Service Am
New Service Volts Overhead ❑ Undgrd ❑ No.of Meters
Amps Volts Overhead ❑Number of Feeders and Ampacity Undgrd 0 No.of Meters
Location and Nature of Proposed Electrical Work:
Generator Installation w/30'trench
Completion of the following table may be waived by the Inspector of Wire:
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of
No.of Luminaire Outlets No. No. formers A 22
of Hot Tubs
No.of Luminaires Generators 1 KVA
Swimming Pool Abovernd. ❑ In-rnd. ❑ No.of Emergency Lighting
No.of Receptacle Outlets No. Batte Units
of Oil Burners
No.of Switches No.of Zones
No.of Gas Burners No.of Detection and
No.of Ranges No.of Air Cond. Total Initiatin. Devices
No.of Waste Disposers Heat Pump NumberTonsons No.of Alerting Devices
Totals: KW No.of Self-Contained
No.of Dishwashers `-Detection/Alertin Devices
Space/Area Heating KW
No.of Dryers Local 0 Municipal 0 Other:
Heating Appliances Connection
No.of Water KW Security Systems:*
Heaters KW No.of No.of No.of Devices or •uivalent
Si ns Ballasts Data Wiring:
No.Hydromassage Bathtubs No.of Devices or E•uivalent
No.of Motors Total HP Telecommunications Wiring:
OTHER: No.of Devices or E•uivalent
Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires.
Work to start: 09/29/2020 (When required by municipal policy.)
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
coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE:INSURANCE � that such
0 BOND 0 OTHER 0 I certify,under the pains and penalties o (Specify:)
FIRM NAME: /perjury,that the information on this application is true and complete.
RANDALL C AGNEW
Licensee: Randall C Agnew
Signature
(If applicable,enter'exempt"in the license number line.)
Address:381 OLD FALMOUTH RD, MARSTONS MILLS MA 026481555 LIC.NO.: 17492
Bus.Tel.No.:
Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety
OWNER'S INSURANCE WAIVER:I am aware that the License does not have the"liability insurance coverage normally required by1
signature below,I hereby waive this requirement.I am the(check one)
qaw.But
❑ owner 0owner's agent.
Signature
Telephone No.
- --1Zwr._ti / PERMIT FEE:$75.00
f 64 /0 //2D kg.