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HomeMy WebLinkAboutBLDE-23-19846 11/15/23,6:34AM about:blank Commonwealth of Massachusetts -© Y.44,,s„F * Town of Yarmouth ,• � c ELECTRICAL PERMIT .\‘ , rx Job Address: 84 PINE ST Unit: Owner Name: RADLEY RICHARD A RADLEY CHRISTINA H Owner's Address: BOX 755 Phone: Email: Purpose of Building Residential Utility Authorization No.: Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19846 Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters: New Service Amps/Volts Overhead ❑ Underground❑ No. of Meters: Description of Proposed Electrical Installation: Replacement generator 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: $ 1 Work to Start: November 13, 2023 FIRM NAME: License Number: Master/System and/or Journeyman Licensee: RICHARD T MCKENZIE License Number: 28006 Security System Business requires a Division of Occupational Licensure "S" LIC. License Number: Address: SOUTH DENNIS, MA, 026602359 SOUTH DENNIS MA 026602359 Fee Paid: $50.00 Email: richmckenzie55@yahoo.com Business Telephone: 508-776-3361 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: ( t/C k /—Z__—S, e--; .. about:blank 1/1 l.,onsnwnloaafth oil///aaeachtuelfa Official Use Only P �. s Permit No. -3-- t�1 L( MI'., s ar�nf oP ira arviced t:;' �` Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] • (leave blank) i • APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (.. I (PLEASE PRINT IN INK OR TYPE ALL INFORM4 TION) Date: //--//— �3 City or Town of: YARMOUTH To the Inspector of Wires: 4) By this application the undersigned gives notice of his or her intention to perform the electrical work described below. '� Location(Street&Number) .854 t%�e_, S7A-e_e_/ Owner or Tenant ,4";je ,Pa / y ' Vie Owner's Address Telephone No. . Is this permit in conjunction with a building permit? Yes n No w Purpose of Building sue. ER'' (Check Appropriate Box) `�, ef��..- Utility Authorization No. Existing Service .:200 Amps /gyp/�js Volts Overhead Undgrd!J�/ / No.of Meters New Service Amps / Volts Overhead Undgrd No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: j J /Peed 44,e,e2;06,<. Completion of the followin&table may be waived by the In ector of Wires. No.of Recessed Luminaires No.of No.of Ceil:Susp.(Paddle)Fans Total No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting No.of Receptacle Outlets d Bane Units No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches Na.of Gas Burners No.of Detection and No.of Ranges Initiating Devices No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers eat'ump 'umber ons �• `o.o e - ontame Totals: .-....._...................._.. No.of Dishwashers Detection/Alertin l Devices Space/Area Heating KW Local 0 unicip. No.of Dryers Connection ❑ Other t Y Heating Appliances KW ecunty ystems: `o.o `eater . No.of Devices or E uivalent Heaters °'° �° ° ' Data Wiring: Si s Ballasts No.of Devices or Es uivalent No.Hydromassage Bathtubs No.of Motors a ecommumcatsons �'irmg Total HP No.of Devices or E•uivalent OTHER: Estimated V31ue olectrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work toted ! — (When required by municipal policy.) -23 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 cove ge is in force,and has exhibited proof of same to the p it issuing office. CHECK ONE: INSURANCE [BOND ❑ OTHER I certify,under the Ain and penalties o 0 (Specify:)����f � filet. FIRM NAME:� , fperjury,that the in vrmation on this application is true d complete. ,_ y Licensee: �Q'v LIC.NO.: �` � f� (If applicable,enter"erem "in the license :ember l e) Signature • LIC.NO.: Address: ,� �1e �,a;r/ s Bus.Tel.No. 336/ *Per M.G.L.c. 147,s. 57 6cY,security work requires Deparimentof Public Safety" License:--------- Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insuranc coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)(] Owner/Agent owner ❑owner's a_ent. Signature Telephone No. PERMIT FEE:$