HomeMy WebLinkAboutBLDE-23-001564 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-23-001564
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 IN INK OR TYPE ALL INFORMATION) Date:9/26/2022
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) 1 KENCOMSETT CIR
Owner or Tenant PAMELA PARKER Telephone No.
Owner's Address YARMOUTH PORT,MA 02675
Is this permit in conjunction with a building permit? Yes Cl 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 18
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
Tong
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 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 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 at 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 my
signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent.
Owner/Agent /� \
Signature Telephone No. PERM] FEE:$50.00
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i- Occupancy and Fee Checked
` — BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07]
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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:
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) 1 Kencomsett Circle
Owner or Tenant Pamela Parker Telephone No. 954-803-1291
Owner's Address same
Is this permit in conjunction with a building permit? Yes Ti No K (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service 100 Amps 120 /2 4 0 Volts Overhead K 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 W/ 20' trench
Completion of the following table may be waived by the Inspector of Wires.
. ofTotal
No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans T
Transformers KVA
No. of Luminaire Outlets No. of Hot Tubs Generators 1 KVA 18
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
of
No. of Switches No. of Gas Burners No. In Detention and
Initiating Devices
No. of Ranges No. of Air Cond. Total No. of Alerting Devices
g Tons
No. of Waste Disposers Heat Pump Number Tons KW No. of Self-Contained
p Totals: Detection/Alerting Devices
No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other
Connection
No. of Dryers Heating Appliances KW Security Systems:*
rJ' No. of Devices or Equivalent
No. of Water No. of No. of Data Wiring:
Heaters KW Signs Ballasts No. of Devices or Equivalent
dromassa a Bathtubs No. of Motors Total HP Telecommunications Wiring:
No. H
Y g 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: 10/22/2022 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 ❑ BOND ❑ OTHER ❑ (Specify:)
I certify, under the pains and penalties of perjury, that the informati on this application is true and complete.
FIRM NAME: RCA Electrical Contractors Inc. fig =NE . 4926
Licensee: Randall C. Agnew Signature r _ kIe:1CO•:
(If applicable, enter "exempt" in the license number line.) ::----Bus. Tel. No.: 508-428-0449
Address: 153 Commercial Street Mashpee, MA 02649 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) ❑ owner ❑ owner's agent.
Owner/Agent PERMIT FEE: $
Signature Telephone No.