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HomeMy WebLinkAboutBLDE-23-19654 10/1'12'2.,8:08 AM �C62 about:blank k,0 Commonwealth of Massachusetts * Town of Yarmouth � , � • y ��� ELECTRICAL PERMIT Job Address: 1261 ROUTE 28 Unit: Owner Name: CAPE COD VERANDA LTD Owner's Address: 1261 ROUTE 28 Phone: Email: Purpose of Building Commercial Utility Authorization No.: Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19654 Existing Service Amps/Volts Overhead ❑ Underground❑ No. of Meters: New Service Amps/Volts Overhead❑ Underground❑ No. of Meters: Description of Proposed Electrical Installation: Panel replacement&four new circuits. 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 El 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: $2,800 Work to Start: October 10, 2023 FIRM NAME: License Number: Master/System and/or Journeyman Licensee: ERIC SOKOLOWSKI License Number: 58821 Security System Business requires a Division of Occupational Licensure "S" LIC. License Number: Address: 6 Susan Circle Norton MA 02766 Fee Paid: $80.00 Email: ericsokolowski6@gmail.com Business Telephone: 508-369-6425 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: about:blank 1/1 • R E C E!;Va D T � 0 202'bm nwealth ofMassachusetts O frcial Use Only/, cli C 1 Permit No.: Z1-- (`i 1! -_-4 ;/ .. TM p•rtment of Fire Services Occupancy and Fee Checked: = 1,5 �8�A 2D O -F1 E 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 electrical work described below. Location(Street&Number): 1z.a)1 ROVrt ,{ Unit No.: Owner or Tenant: 1( e\ `atKo Email: CLA. , iltkk4991AiGLA.GOVtr► Owner's Address: 72.6i• Rd Ukt. Phone No.: r Poll' f iy-c9oi Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No❑Permit No.: Purpose of Building: AC.At1 Utility Authorization No.: Existing Service: iw'J Amps ;;ZO / old Volts Overhead❑ Underground❑ No.of Meters: . New Service: Amps / Volts Overhead 0 Underground❑ No.of Meters: Description of Proposed Electrical Installation: R (ac— 66+1 JNI PCIJA V\ N't O�"1 1-1`� Gikrl ) \-S rrO v 6k J � 41 'ci4ALt k\-G NeAA 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❑ No.of Devices: Swimming Pool:In-Grnd.❑ Above-Grnd.El Hot-TubEl 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 El Ground-Mount0 Level I ❑ Level 2 El Level 3 El Rating: OTHER: ;' sut,Pktitt\v1,111.k Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Elec3rical Work:y, I'' (When required by municipal policy) Date Work to Start: /Oil 0/2..3 Inspections to be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: k1i `33 Wglti-, -V,ItC1-1.1C eth F-1-C A-1 ❑ or C-1 0 LIC.No.: Master/Systems Licensee: / C LIC.No.: Journeyman Licensee: i--1`5 f✓Yi So��b"1 �C` LIC.No.: s-S`62l Security System Businessne requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: Address: ( c J to 6\itt C\)04'k-G'*A tA, 0 te' Email: gric50k.oiov4SILt 4p11N10,r1 ,C,OM Telephone No.: TOT-3G -a/zc I certify,under the pains and penalties of perjury,that the information on this application is true and complete. Licensee: Q.,. ' 1 .'l Print Name: � l' �©16d'O 1 k, Cell.No.: -0`rf-36c/-C 42<- INSURANCE COVERAGE: 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 ame to the permit issuing office. CHECK ONE: INSURANCE[n BOND 0 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.: