HomeMy WebLinkAboutBLDE-23-15937 5/25/23, 1:49 PM about:blank
Commonwealth of Massachusetts oF. A.=?
* v . d { 'Town of Yarmouth a of
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ELECTRICAL PERMI -,it - �� `
Job Address: 668 ROUTE 28 Unit:
Owner Name: MANNING GERALD TRS THE PARKER RIVER REALTY TRUST
Owner's Address: 121 MAYFLOWER TERR Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-15937
Existing Service Amps/Volts Overhead ❑ Underground 0 No. of Meters:
New Service Amps/Volts Overhead 0 Underground❑ No. of Meters:
Description of Proposed Electrical Installation: wire bathroom &enclosed bar area (508-332-6985)
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: 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 ❑ 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: $ 7,500 Work to Start: May 25, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: REX A BURGER License Number: 17037
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: 2045 Main Street Marstons Mills MA 02648 Fee Paid: $100.00
Email: rburgerelectric@gmail.com Business Telephone: 508-332-6985
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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Commonwealth of Massachusetts Official Use O
_ == Permit No.: /3 0e—Z..i'. 7 `i
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'l�l;"— � Department of Fire Services Occupancy and Fee Checked:
`I - BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
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WI APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 MR 12.00
City or Town of: YARMOUTH Date: 5-/9-5'/2-3
To the Inspector of Wires:By this ap lication,th and rsi ned�g�iv�e��s notices�/ of his or h ntntion to perform the electrical work described below.
Location(Street&N mber):_ 66s /L/j - a-,Y 1.t61's+ ll�l!"1�43t. i p169� Unit No.:
Owner or Tenant: L1f'J y �i7a.hn e;{ j p/zi`� g,J- y Email:
Owner's Address: / �•J y Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes pg No❑Permit No.:
Purpose of Building: Utility Authorization No.:
Existing Service: 1 1 1t9b Amps /20 / , -/0 Volts Overhead❑ Underground No. of Meters:
New Service: Amps / Volts i Overhead❑ Underground❑ No.of Meters:
Description of Proposed Electrical Installation: L A.! hU r.J1`-O/Vt bve,ei 4 f-', s�el
P2Z, /-- Mkr--411-
Completion of the following table may be waived by the Inspector of Wires.
No.of Receptable Outlets: No.of Switches: 5 Generator KW Rating: Type:
No.Luminaires: 61 No.of Recessed Luminaires:5- 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.❑ Above-Grnd.❑ 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(quipp n nt: " C D
No.of Modules: Roof-Mount D Ground-Mount 0 Level 1 0 Level 2 0 Leiel 3r'=Rating_. .a-��.
OTHER: P
Y 2 5192 . .
/- co
Attach additional detail if desired,or as wired by the Inspector of Wires. 7."
( q iy munici $' 'r jNT
Estimated Value of Electrical Work: ,i 2 When re wire ai oNhc -
Date Work to Start: 5/2..5/23
Inspectiont to be requested in accordance with 1VTET ule 10,and upon completion.
FIRM NAME: R€ ijidysz Fl,�`�" i� �.� L A-1 El or C-1 0 LIC.No.:
Master/Systems Licensee: , U LIC.No.: A 1 '0 3 4'
Journeyman Licensee: LIC.No.:
Security System Business requ/i�re�s�a Division of Occupational l Licensure"S"LIC.1 .S--LIIC.No.:
Address: 9 l' 5 1 —,`, �t ' M.GICs s , 4 4s a2.4 Li 3 Email: \ t;,.Q r RitAyr L!fill C., /VyA)t a,to 1v1 Telephone •No.: 54 ^5)2 - /85-
I certify,under the pains and penalties of perjury,that the i rmation on this application is true and complete.
Licensee: Print Name: l' -; ).- / r
��� ��i� Cell.No.: �� (ra��
INSURANCE O ERAGE: Unless waived by the owner,no permit for the perfo ance 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 ame to the permit issuing office.
CHECK ONE: INSURANCE BOND El OTHER El
OWNER'S INSURANCE W IVER: 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.: