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BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07]
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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: 7/13/2023
City or Town of: S.Yarmouth To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street& Number) 881 Route 28
Owner or Tenant Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes 0 No 2 (Check Appropriate Box)
Purpose of Building Commercial Utility Authorization No.
Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters
New Service Amps I Volts Overhead 113 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: UNIT 2307- Replace 20a circuit in kitchen, replace switch and
receptacle devices within unit.
Completion of the following table may be waived by the Inspector of Wires.
No.of Total
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA
E
o No.of Luminaire Outlets No.of Hot Tubs Generators KVA
o
• Above ri In- ri No.of Emergency Lighting
I- No.of Luminaires Swimming Pool grnd. 1=1 -
ornd 1=1 Battery Units
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co
a) No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Detection and
in No.of Switches No.of Gas Burners Initiating Devices
._
E No.of Ranges No.of Air Cond. Total
Tons
No.of Alerting Devices
CL No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices
6.
4--. No.of Dishwashers Space/Area Heating KWOther
Local ElMunicipal Connection El
..._.
Security Systems:*
E
No.of Dryers Heating Appliances KW
cu No.of Devices or Equivalent
0_ No.of Water No.of No.of
KW Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
Fs
E No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
LU No.of Devices or Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
2500
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: 7/17/2023 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 1:1 BOND El OTHER E (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Interstate Electrical Services Corporation / LK.NO.: 3075A1
Licensee: James P. Alibrandi Signatu e Lic.NO.: 1 4026A
(If applicable. enter "exempt"in the license number line.) Bus.Tel.No.: 855-500-4372
Address: 70 Treble Cove Road, No. Billerica, MA r61 B2 Alt.Tel.No.: 978-947-4372
*Per M.G.L. c. 147.s. 57-61,security work requires Departelt of Public Safety"S"License: Lic.No.
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)ID owner El owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $
7/18/23,6:19 AM about:blank
Commonwealth of Massachusettsv . y �a;
* Town of Yarmouth
ELECTRICAL PERMIT
Job Address: 881 ROUTE 28 Unit:
Owner Name: YM OWNER LLC
Owner's Address: 1264 MAIN ST Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19100
Existing Service Amps/Volts Overhead ❑ Underground 0 No.of Meters:
New Service Amps/Volts Overhead 0 Underground 0 No.of Meters:
Description of Proposed Electrical Installation: UNIT 2307 - Replace 20a circuit in Kitchen, and replace switch/receptacle
devices in unit
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.❑ Hot Tub 0 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 ❑ 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: $2,500 Work to Start: July 18, 2023
FIRM NAME: License Number: 3075A1
Master/System and/or Journeyman Licensee: JAMES P ALIBRANDI License Number: 14026
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number: S"50.3"ZZh-T
Address: WESTFORD, MA, 018862064 WESTFORD MA 018862064 Fee Paid: $100.00
Email: permits@iesc1.com Business Telephone: 8555004372
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: Starr Indemnity& Liability Co
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