HomeMy WebLinkAboutBLDE-23-19322 8/11/23, 7:13 AM about:blank
Commonwealth of Massachusetts , c 4411,
* Town of Yarmouth
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ELECTRICAL PERMIT -
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Job Address: 99 OLD HYANNIS RD Unit:
Owner Name: JOHNSON JEFFERY TR 37737 REALTY TRUST
Owner's Address: PO BOX 960 Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19322
Existing Service Amps/Volts Overhead El Underground❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground Cl No. of Meter§:
Description of Proposed Electrical Installation: Temporary service(W/O#: 14105990) V.sailfeA `� 6 A5
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❑ No.of Devices:
Swimming Pool: In-Grnd.❑ Above-Grnd.❑ Hot Tub El 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 ❑ No.of Outlets:
No. Energy Storage Systems: KWH Storage Rating: Security System El 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❑ Level 1 ❑ Level 2❑ Level 3 Cl Rating:
Estimated Value of Electrical Work: $ 500 Work to Start: August 10, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: SCOTT R CONDINHO License Number: 24173
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: W HYANNISPORT, MA, 026720521 W HYANNISPORT MA
026720521 Fee Paid: $50.00
Email: scottcondinho(&gmail.com Business Telephone: 508-364-4139
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:
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at * st o nwaa Permit No.}'3 i
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BOARD OF FIRE PREVENTION REGULATIONS (Rev. 1/07]xle (leave blank)
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APPLICATION FOR PERMIT TO PERFC - M 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: &iio/23
City or Town of: kit,ie,,,....6 w`7 h To the Inspector of Wires:
By this application the undersign& gives notice of his or her intention to perform the electrical work described below.
Location(Street&Numberlig 0 c.:0 t-4,1 s,0i i',, i i artw,(4:,cr.,pci l`T- ivi n
Owner or Tenant 3./7 37 A 1/4 r i �,
z .�y LCa rrt. 1)c,.�,, t,ba..).. Telephone No.
Owner's Address lei j,. ( i i 1-,(n,-. ,;
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No. LAY I kf/. 0
Existing Service Amps _ / Volts Overhead❑ Undgrd❑ Ni' of�t'`�rotors
New Service Amps / =: Volts Overhead 0 Undgrd❑ -N :o'E�hf U
Number of Feeders and Amply = 9 )
Location and Nature of Proposed Electrical Work: r Ct viti �; wz�,Lr�
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3UIL� �y p : {:Pni�1TMCNT
Completion of the following maybo a, byte t es.
No.of .F [`
tit No.of Recessed Luminaires No.of Cell.-Snap.(Paddle)Fans Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above In'.. No.of Emergency Lighting
stu , rnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
-No.of Detection and
No.of Switches No.of Gas Burners Initiating Devices
To
l , No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers -Meat Pump Number Tons KW No.ot`Self-Contained
ci
P Totals Detection/Ale Devices
F Municipal
No.of Dishwashers Space/Area Heating Local❑ Connection L thber
No.of Dryers Heating Appliances KW Security S , }r s:*
No.of i - ces or Equivalent
v No.of Water K , No.of No.of Data Wiring:
Beaters Signs Ballasts No.of Devices or gquivalent
'L--1 No.A dro Bathtubs No.of Motors Total HP TelecommunicationsWirtn :
yNo.of Devices or Equivalent
OTHER:
Attach additional detail rf desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: .,-s_ (When required by municipal policy.)
Work to Start: sj i<:1,2i 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 Er BOND Q OTHER 0 (Specify:)
I certify,under the pains and penalties of perjtoy,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:
Licensee: 5.: t+ s2.,Ce.eaiUa,1% Signature y? _,,.er LIC.NO.: 2yr73 ,4.
(If applicable,enter"exempt'in the license number line) Bus.Tel.No,:,-ct-3 0-.-d r 3'i
Address: i_c , . 3'Z. w '.s/:.m. c .4 7 z Alt.TeL No.:
*Per M.G.L.c. 147,s.57-61,security work requires l)epartment of Public Safety"S"License: Lie,No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required bylaw. By my signature below,I hereby waive this requirement. I am the(check one)0 owner Downer's agent.
Owner/Agent PERMIT FEE:$
Signature Telephone No.