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HomeMy WebLinkAboutBLDE-23-19640 10/6/23, 1:39 PM about:blank Commonwealth of Massachusetts wog y ' o *.4° Town of Yarmouth c. O?°<:ems �, y ELECTRICAL PERMIT �, 9 * Job Address: 1175 ROUTE 28 Unit: Owner Name: TOWN OF YARMOUTH Owner's Address: 1146 ROUTE 28 Phone: Email: Purpose of Building Commercial Utility Authorization No.: Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19640 Existing Service Amps/Volts Overhead ❑ Underground❑ No. of Meters: New Service Amps/Volts Overhead❑ Underground❑ No. of Meters: Description of Proposed Electrical Installation: Activate distribution panels& receptacles for Seaside Festival event 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❑ 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: $ 0 Work to Start: October 6, 2023 FIRM NAME: License Number: Master/System and/or Journeyman Licensee: JESSE J MACKENZIE License Number: 13111 Security System Business requires a Division of Occupational Licensure "S" LIC. License Number: Address: S YARMOUTH, MA, 026644156 S YARMOUTH MA 026644156 Fee Paid: $0.00 Email: mackenzieelectric@gmail.com Business Telephone: 774-268-2791 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 o, its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. INSURANCE: W. ( 723 v _. about:blank 1/1 RECEIVED O *'�•_ i ommonwealth ofMassachusetts Official Usg91nl , -_— 2023 Permit No.: CZ� _aL-t 11�;= Department of Fire Services Occupancy and Fee Checked: _ BUIL'I= — 4 ` ,^ [Rev. 1/2023] By _ ►( 54 �OARI► OF FIRE PREVENTION REGULATIONS 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: /0--6'•-0. " To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the electrical work described below. Location(Street&Number): iris 0 Os Unit No.: Owner or Tenant: /y/1•4i,..r t4 L..c 4c( cq yorir,"aW..Email: Owner's Address: //5�6 �et-- „2.3 Phone No.:, "398- ;0 Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No❑Permit No.: Purpose of Building: Utility Authorization No.: _ Existing Service: dc►v Amps /ell, /2 �4 i 0 Volts Overhead❑ Underground VINo. of Meters New Service: Amps / Volts Overhead❑ Underground 0 No.of Meters: Description of Proposed Electrical Installation: _....- 0 ,,, v� nt c..ra \ 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.❑ Hot-Tub❑ 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❑ 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❑ Level 1 ❑ Level 2❑ Level 3 0 Rating: OTHER: Attach additional detail if desired,or as required by th ns ector of Wires. Estimated Value of Electrical Work: //lChni G_ (When required by municipal policy) Date Work to Start:/0-6:—,?U,:C Inspections to be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: UxtP /Y1nek-ri C-i-ne/C 0A l A-1 ❑ or C-1 ❑LIC.No.: i..?J/l"?j Master/Systems Licensee: LIC.No.: Journeyman Licensee:'07 e_ /l itleKv e/e LIC.No.: l.311/^S' Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: Address: T iC 1V4efrrAp_ ` 60740"/ zi,p,/C'_ -Sf.I Vq,Qi' ek.,1-1--©P L� Email: 4C° h/L/e !N<`I eiC c'- 6. 1 l- 0 G Telephone No.:77�`a( a79/ I certify,and the pains a allies of perjury,that the information on this pplication is true and complete.• / p, Licensee: I?/r" Print Name: '37 -, /���Pi1lC,/? Cell.No.: 7? J QI7 C ( INSUR E COVERAG : Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provi s of of liability including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is i e and has exhibited proof of same to the permit issuing office. 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❑ Owner's agent❑ Owner/Agent: Tel.No.: Signature: Email.: