HomeMy WebLinkAboutBLDE-23-18984 2/23,7:05 AM about:blank
Commonwealth of Massachusetts
* Town of Yarmouth �
ELECTRICAL PERMIT
Job Address: 103 MID-TECH DR UNIT C Unit:
Owner Name: TOBELMAN SUSAN C TRS HOUGHTON M ODONNELL G KARRAS S
Owner's Address: 103C MID TECH DR Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-18984
Existing Service Amps/Volts Overhead ❑ Underground❑ No.of Meters:
New Service Amps/Volts Overhead 0 Underground 0 No.of Meters:
Description of Proposed Electrical Installation: Replacement HVAC&add receptacle
No.of Receptacle Outlets: 1 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 0 No.of Devices:
Swimming Pool: In-Grnd.❑ Above-Grnd.0 Hot Tub 0 No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: 1 Video System ❑ No.of Devices:
No.Air Conditioners: 1 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 0 Ground-Mount 0 Level 1 0 Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1,500 Work to Start: June 20, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: ADAIR MARTINS License Number: 23369
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: OSTERVILLE, MA, 02655 OSTERVILLE MA 02655 Fee Paid: $80.00
Email: info@mrcapeelectrician.com Business Telephone: 508-301-2655
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 OnI
i�=-: Permit No.: G23 — no
u_ -i't Department of Fire Services Occupancy and Fee Checked:
j=•" BOARD OF FIRE PREVENTION REGULATIONS [Rev.p1/2023]
TS
'> —' 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: 06I2 j/2_3
To the Inspector of Wires:By this application,the undersigned gives notices of of her tention to perform the electrical work described below.
Location(Street&Number): 103 'I�� Dr L G Unit No.:
Owner or Tenant: le.44 l�.i cl o S 60 p� imps, a,�5 Email: 31e,t,p, trade. c o Sc irn .iyli-S_too
Owner's Address: ` Phone No.: Sp2 '- H-}'L�-- i ZZ j
Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No[''Permit No.:
Purpose of Building: owl . ej aik Utility Authorization No.:
Existing Service: Amps / Volts Overhead 0 Underground 0 No. of Meters:
New Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:
Description of Proposed Electrical Installation: Q .- C c a2. I v R t ar e j- eti dgfet5
UN;-\- evil.de, '.t a 4101?a) co_i vice_ e iiiq For C.13 l.,(enSQ."'
Completion of the following table may be waived by the Inspector of Wires.
No.of Receptable 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 0 No.of Devices:
Swimming Pool:In-Grnd.❑ Above-Grnd.0 Hot-Tub 0 No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System Y ❑ 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 0 Ground-Mount 0 Level 1 0 Level 2 0 Level 3 0 Rating:
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: * 15 UCH
(When required by municipal policy)
Date Work to Start: C6/20i23 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: Mg_,C_a E kcc-n Cat , C A-1 ❑or C-1 ❑LIC.No.:
Master/Systems Licensee:air
r h n S `, (L LIC.No.: 3 369 -^
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Journeyman Licensee: 4cia.,/tr Vict,rhyl S. `S 2 LIC.No.: 5'S 6 78
*
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: "
Address: g (i ni of v n,Z.c.�,4j cm \&t 2J-1- v rvi S [vt A- t 6 o
Email: 'a O �L..1�C'_ �.r-t 1 so
fit? � � � Telephone No.: �C1 g - -301 - 2.6 S s
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
Licensee: ,Jr
i- --,-( _
INSURAN E COVERAGE: Unlesss/ Print
Name: 4 /a4r 1"l e cTTYI.S, Cell. No.: c�
the2s~ei5 E i }3
permit
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 s e to the permit issuing office.
CHECK ONE: INSURANCE[1 BOND❑ OTHER 0 Specify:
OWNER'S INSURANCE"- . - IA •e_ �I„ . p �'
t-the Licensee does not have the liability insurance coverage normally
required by law.By my sign 7. -*,_-_ i I lier a a this requirement.I am the:(Check one)Owner❑ Owner's a ent
Owner/Agent: g ❑
Tel.No.:
Signature: J U N 2 0 2023
Email.:
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