HomeMy WebLinkAboutBLDE-23-15900 • Commonwealth of Massachusettsvitysto-Is
* Town of Yarmouth
O
ELECTRICAL PERMIT
Job Address: 88 OLD MAIN ST Unit:
Owner Name: TOWN OF YARMOUTH
Owner's Address: 1146 ROUTE 28 Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-15900
Existing Service Amps/Volts Overhead 0 Underground 0 No.of Meters:
New Service Amps/Volts Overhead O Underground 0 No.of Meters:
Description of Proposed Electrical Installation: replace defective&malfunctioning overhead meter socket/main breaker with
new overhead meter socket(774-836-5877)
No.of Receptacle Outlets: No.of Switches: Generator KW Rating: Type:
No.Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA:
Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW:
No. Heat Pumps: Total KW: Total Tons: Fire Alarm System t] No.of Devices:
Swimming Pool: In-Grnd.❑ Above-Gmd.CI Hot Tub❑ No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices:
No.Air Conditioners: Total Tons: Telecom System ❑ No.of Outlets:
No. Energy Storage Systems: KWH Storage Rating: Security System ❑ No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment:
No.of Modules: Roof-Mount❑ Ground-Mount 0 Level 1 0 Level 2❑ Level 3 0 Rating:
Estimated Value of Electrical Work: $0 Work to Start: May 5, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: WELLINGTON R SOARES License Number: 21075
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: 110 Breeds Hill Road HYANNIS MA 026011864
Email: info@wrselectrian.com Business Telephone: 774-836-5877
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.
INSURANCE:
e.
�� , �
RECEIVE' ®
HAY 05 2023
BUILDING DEPARTMENT
Co, 47W Official Use Only
a c� Permit No. 8 DI Z3 %-WOO
e� �t 2 apartmant el. ire Serviced
...et r.
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: U,.r ,0 Z . Z,3
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned Wotice of his or her intention to perform the electrical work described below.
43 Location(Street&Number) [ ll M 41 W S I1 6TN "fl- - 1 , c-VP i -lt-e+-bov-1 4-
i. Owner or Tenant Vs/2{ � �t Telephone No. .517d- 3 ' 2X 2-o
I
Owner's Address
Is this permit in conjunction with a building permit? Yes ElNo ❑ (Check Appropriate Box)
— —
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd El No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: t.2.. cLe C,Gt.v, ,t ryy f` p`
a s �Y•filir��iL J'✓LC�/�if'/1� i'U(i�,�' � t;YZG�.�st�7iL((�J Gt Yle-fit3 e'V-(�l. /`� �
• '�_-t9- 1 . Completion o the ollowin table maybewaived Wires,
vu A 1 )` g arved by the lnspecfor of Wrres,
Ui No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tranf TV
sformers KVA
otal
! Tran
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
st- No.of Luminaires SwimmingAbove In- No.of i,'mergency Lighting
Pool grad. ❑ grnd. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
h No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
t li No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
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 ❑ ��
Connectionos
No.of Dryers Heating Appliances KW Security
Devicest or Equivalent
No.of He WastR#ems KW No.of No.of Data Wiring:
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: 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 exhibi ed 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: 1dJ 2 Ley (M -c is el A-r ) 110£ LIC.NO.: 2107.S A
Licensee: V-) a L4,, ./d•E��ignature
y LIC.NO.: 4 37 6 13
(If applicable,enter"exe�rpt' i te�liicense number l'ne.) Bus.Tel.No..�bo 77S S 9%
Address: /T D S a2„ 1-1 y L(_ PO4-i / Alt.Tel.No.: 77 S� ;i' 5 f e77
*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 ❑owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE: $ 0t