HomeMy WebLinkAboutBLDE-23-19966 12/6/23,5:14 AM about:blank
Commonwealth of Massachusetts
* �� Town of Yarmouth °C.
t 4e F�n ' �,$
ELECTRICAL PERMIT ' ''
Job Address: 476 ROUTE 6A Unit:
Owner Name: NICK AND JAY ENTERPRISES INC
Owner's Address: 381 CAMP ST Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19966
Existing Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Wiring for two gas dispensers, two pumps, tank monitoring, & Island lights.
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: In-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 D 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: $ 8,500 Work to Start: December 4, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: EDWARD F KEDDIE License Number: 18247
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: ROSLINDALE, MA, 021311918 ROSLINDALE MA 021311918 Fee Paid: $100.00
Email: efkeddie@gmail.com Business Telephone: 617-571-2396
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:
Le-
1
C. �It,T (PJ� /�a "'/GYs) �1 17 (�
,,y,k-0/? iv*L.oi%ir.i. of 1'Sn'o, ok_ /2/2/Zi
1/1
about:blank
12,e.ctct
w 'gCEIVED
w-C,dL,
�� , Official Usg Only
1_ = 2023 •mmOnwealth of Massachusetts permit No.:�Z3 —C 7
,� -- Department of Fire Services Occupancy and Fee Checked:
BUI`: "gal /•KTMENT [Rev. 1/2023]
By =1--►-E___ _ �._.' OF FIRE PREVENTION REGULATIONS
.�y''•-''14 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL W RK
All work to be performed in accordance.with the Massachusetts Electrical Code(MEC), 527 R 2.00
City or Town of: YARMOUTH Date:
To the Inspector of Wires:By this applicati n,the un ler igned gives notices of his or her intention to perform the electri al w described below.
Location(Street&Number):� Unit No.:
Owner or Tenant: C 7(?0,7 P iq c'a A i Email:
Owner's Address: 5 e Phone No.:
Is this permit in conjunction with a buill in ermit?(Check appropriate box)Yes❑ No Permit No.:
Purpose of Building: 4e/7'7 G a e Utility Authors ation No.:
Existing Service: Amps / Volts Overhead❑ Underground❑ No. of Meters:
New Service: Amps / Volts Overhead Underground❑ No.of Meters:
L /'
Description of ropos d Electrical I stallation: a.,//%t/ T/,>� D, GAS ,U41,-4S S, c,2®v.s p
/�� Li A f, ,4 / -1n�C ,�n,a,A/ Y J Sy�S/e !' �/
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:L Total HP:#‘. Total KW:
No.Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ 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 ❑ No.of Device .
No.Air Conditioners: Total Tons: Telecom System❑ No.of Outl s:
No.Energy Storage Systems: KWH Storage Rating: Security System ❑ No.of Deyices„�
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equip nt:}' h --` tP V
No.of Modules: Roof-Mount❑ Ground-Mount 0 Level 1 0 Level 2❑ Level 3❑ Ralfng:U�� � Q
OTHER: aeU�� 061
0?3
Attach additional detail if desired,or as r u(i� � N
red by the Inspector of Wires. \�tigRT
Estimated Value of Electrical rk: C5 ,5-0 (When required by municipal poll � r `
Date Work to Start: 7 Inspectionsec to be requested in accordance with MEC Rule 10,and upon coin i .
FIRM NAME: /�, ,i ( 'Cc v%`Cto . A-1 0 or C-1 0 LIC.No.:
�
I / / 1' LIC.No.: /��1'y�/�l
Master/Systems Licensee: 1,�/Irls/G _F/����� � C/�il!
Journeyman Licensee: A1�(/ f //l C' ( LIC.No.: j' /.f C
Y
Security System Business requiresia D. ision of Occupational Licensure"S"LIC./ ,S---LLIC.No.: 2 /
Address: 10 fi' S/ �.(/✓. 4 cn/c j /'J/r� Q /3/
Email: Telephone No.:
I certify,untie t pair and penaltie (perjury,that the information on this appli ati n,is true and complete.le �j'
Licensee:
Print Name: � •i t///2�" F' l E Cell.No.• (l/'�i� ��/
INSUR CE CO RA : Unless waived by the owner,no permit for the perfo ance 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 o same to the permit issuing office. S
CHECK ONE: INSURANCE
Specify:
BOND❑ OTHER❑ P fY:
OWNER'S INSURANCE WA VER: 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 El Owner's agent❑
Owner/Agent: Tel.No.:
Email.:
Signature:
�� m / Cd 4/0 U .
- e � � , , Ins e >�cY1 Q,
- SSD