HomeMy WebLinkAboutBLDE-23-18991 UNIT 19 6/23/23,7:53 AM about:blank
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ELECTRICAL PERMIT A
Job Address: 77 ROUTE 28 Unit:
Owner Name: THE VILLAGE CENTER GROUP
Owner's Address: 19 HIGHLAND ST Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-18991
Existing Service Amps/Volts Overhead 0 Underground 0 No.of Meters:
New Service Amps/Volts Overhead 0 Underground 0 No.of Meters:
Description of Proposed Electrical Installation: Recessed lighting & upgrade devices (Unit 19)
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 Poor In-Grnd.0 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 ❑ 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❑ Ground-Mount❑ Level 1 ❑ Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: June 20, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: NATHANIEL MARCHANT License Number: 53813
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Mattapoisett, MA, 027392311 Mattapoisett MA 027392311 Fee Paid: $80.00
Email: nathaniel.electric@gmail.com Business Telephone: 774-762-6249
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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, jam JUN 20 2t!23 t Afficial Use Only,
_ Commonwealth of Massachusetts Permit No.: [�-ficia I. ,� k
'� * 1'�� �/ -if=i'ARI r\bepCartment of Fire Services Occupancy and Fee Checked:
"° - * BOARD(OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
'''•- APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527 CMR 12.00
City or Town of: YARMOUTH Date:
To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the electr work described below.
Location(Street&Number): 77 /4 1 `<, v+'t;Es I rt t 11, 16 Unit No.: I R ,
Owner or Tenant: f/y?5;yy-J y G,/,-n.(IS /14 a le/ Email:
Owner's Address: Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No Ei Permit No.:
Purpose of Building: /'/0 f e/ Utility Authorization No.:
Existing Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:
New Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:
Description of Proposed Electrical Installation: 2 l't 5 /a l/ re re sJec /J y/)f5, 7e10 fG, Cit 0/
:
r7U leTS t Suis- cho5 , /9 SIa // i7/211- 2 //�/is a o/rE,J/i / how -err
Completion of the following table may be waived by the Inspector of Wires.
No.of Receptable Outlets:/< No.of Switches: r! Generator KW Rating: Type:.
No.Luminaires:3 No.of Recessed Luminaires: 41 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 0 No.of Devices:
Swimming Pool:In-Grnd.0 Above-Grnd.0 Hot-Tub 0 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 0 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 0 Ground-Mount 0 Level 1 0 Level 2 0 Level 3 0 Rating:
OTHER:
Attach additional detail if desired,or aquired by the Inspector of Wires.
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Estimated Value of Electrical Work: U v < (When required by municipal policy)
Date Work to Start: 6-,2 0,.2 3 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: J//an/e///, rli.;ew,G L . f/ecif-,G7vv1 A-1 ❑ orC-1 ❑LIC.No.:
Master/Systems Licensee: LIC.No.:
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Journeyman Licensee: /V T c i 1 1/ /441 P,✓ L 6 LIC.No.: f' 5.5 21.E
Security System Business requires a Division
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sioonof Occupational/ Licensure� "S"LIC. S-LIC.No.:
Address: /5 f�cyr�o✓i&,&/ ,/1.ra7T�po' f NA 00275?
Email: -/hem'-eI.e!ec f,G k5"Ka.'/.COWS, Telephone No.: 77 v- 7> 1- 0 V
I certify,under he ains�yl, penalties of perjury,that the information� on this application is true and complete. Q
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Licensee: 7/ p� ,/Ui� ia77/II� C�L7Gv,G Z Cell.No.: 77S 7(2- //
Print Name:
INSURAN COV RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee
provides proof of liability including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage
is in force and has exhibited proof of a to the permit issuing office.
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CHECK ONE: INSURANCE BOND❑ OTHER❑ Specify:
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 El Owner's agent El
Owner/Agent: Tel.No.:
Signature: Email.: