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HomeMy WebLinkAboutBLDE-23-15990 6/5/23,3:18 PM about:blank __ Av Commonwealth of Massachusetts * Town of Yarmouth , ' ELECTRICAL PERMIT Job Address: (9 eA-2 l Unit: Owner Name: — ' r, 1 Owner's Address: v Phone: Email: Purpose of Building Residential Utility Authorization No.: Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-15990 Existing Service Amps 200/Volts Overhead 0 Underground 0 No.of Meters: New Service Amps/Volts Overhead 0 Underground 0 No. of Meters: Description of Proposed Electrical Installation: Finish Basement. No.of Receptacle Outlets: 50 No.of Switches: 8 Generator KW Rating: Type: No. Luminaires: 2 No.of Recessed Luminaires: 34 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❑ No.of Devices: Swimming Pool: ln-Grnd.❑ Above-Grnd.0 Hot Tub❑ No.of Self-Contained Detection/Alerting Devices: No.Oil Burners: No.Gas Burners: Video System ❑ No.of Devices: No.Air Conditioners: Total Tons: Telecom System 0 No.of Outlets: No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of Devices: Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment: No.of Modules: Roof-Mount 0 Ground-Mount❑ Level 1 0 Level 2 0 Level 3❑ Rating: Estimated Value of Electrical Work: $ 1,600 Work to Start: June 5, 2023 FIRM NAME: License Number: Master/System and/or Journeyman Licensee: License Number: Security System Business requires a Division of Occupational Licensure "S" LIC. License Number: Address: Fee Paid: $75.00 Email: Business Telephone: 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: ( 4/3 '1 •,t1 6;,/,144, tora-eiv3 � about:blank 1/1 r Aff fr)deui n/ t_.ommontveala of Plamaeltuut26 1 Official Use Only (0/-/)2_3 cc/�� Cl Permit No. ;23 I S 790 -.. '_ ..U.partmenf 41 ire Services i.s}, � t Occupancy and Fee Checked 4 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 in q. 1 2L 2 City or Town of: Liar(r -01 To the Inspector of Wires: By this application the undersigned gives notice of his or her intenti++ to perform the electrical work described below. Location(Street&Number) - 0-A— - G--- or Tenant _ Ai, Max ". Telephone No,.—).�(. , (o4 7 0 Owner's Address ' —r'l&C Lam? c\ ) ni (vim 7 Q-�;�_ tL\ ( C GCL Is this permit in conjunction with a building permit? I Yes RI No ❑ (Check Appropriate Box) Purpose of Building .pt,,t Svl, Utility Authorization No. Existing Service ` Amps / Volts Overhead❑ Undgrd EN No.of Meters New Service Amps / Volts: Overhead n Undgrd❑ No.of Meters Number of Feeders and Ampacity ` Location and Nature of Proposed Electrical Work: 'i;4el,c,�\1 d)i t"L; ' l 'Ott e. V) Completion of the jollowingtable may be waived by the Inspector of Wires. t1.1 No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total C. Transformers KVA q No.of Luminaire Outlets ffil No.of Hot Tubs 0 Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units '� No.of Receptacle Outlets c No.of Oil Burners 0 FIRE ALARMS No.of Zones No.of Detection and No.of Switches (3' No.of Gas Burners 0 Initiating Devices Tot Ili No.of Ranges i No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers 0 Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers 9 Space/Area Heating KW Local 0 Municipnectioaln 0 Other Con No.of Dryers 0 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 Velecommunieations Wiring: No.of Devices or Equivalent OTHER: 1 i i Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: :l/r(Li) Q( (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 exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND ❑ OTHER ❑ (Specify:) I certify,under the pain, and p allies of perjar);that the information on this application is true and complete. FIRM N LIC.NO.: Lam: __ Signature LIC.NO.: (If aplk ter"exalt"in t kense nanrber line.) Bus.Tel.No. Address: Alt.Tel.No.: *Per M.G c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER 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:$ Je J Qr*/-) G Gh ark'^' .g R 25' 4 11' 14' 1 1 1 • • asir. 2 . • © 4J Oil 1 co c! E • 3 0 —I-I >O .... ar ElEN > zcc 3 i ea i a:\\ r3 cc 7 le m • i 1 • 0 L A ® O co = O cB oC -� Hallway r* Ill I /El° le, ---.4 ,fil cc. 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