HomeMy WebLinkAboutBLDE-24-445 3/20/24,7:00 AM about:blank
Commonwealth of Massachusetts -oF•:Y-4
* Town of Yarmouth 3
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w ;uELECTRICAL PERMIT 0
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Job Address: LONG POND DR Unit: S� 9 -1--- C
Owner Name: NL GROCERY 1 EXCHANGE LLC
PO BOX 6500 AHOLD FINANCIAL
Owner's Address: SVC Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-24-445
Existing Service Amps/Volts Overhead 0 Underground ❑ No. of Meters:
New Service Amps/Volts Overhead 0 Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Installation of 50 amp circuit for(2)chicken ovens.
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 ❑ 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: $2,000 Work to Start: February 28, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: JUSTIN B TALBOT License Number: 20918
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: BROCKTON, MA, 023011022 BROCKTON MA 023011022 Fee Paid: $80.00
Email: projects@ohburg.com Business Telephone: 781-344-0522
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:
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Cmm w�wneatth o`///addachudelli Official Use On1X
.,Ali- Permit No.RZ..L 5-•.,...�(�,i71J eparimeni emir Serviced
� 1' r7 Occupancy and Fee Checked
t, ,, BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 0
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2-2 -24
' City or Town of: '(oil"F('('`lf \ 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)sr1' iC i fl PC�r1c_a Q.G . <t Il—. rr c)L\i-, 1.tY
Owner or Tenant 31? 'sc C ` Telephone No.
Owner's Address
Is this permit in conjunction with a building per®it? Yse ❑ No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Velb Overhead❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work r flr•t.\ \,rn eivpu.-
PC AY -4 r\—'l_hl S tin 51v i' 1 J
VI Completion of the followingtable m be waived by the fn ecfar of Wires.
Lb No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.°� Total
Ve Transformers KVA
CtNo.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming 0 ,Above ❑ In- ❑ No.of N,mergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
FNo.of Switches No.of Gas BurnersNo.of Detection and
Initiating Devices
l
I LI No.of Ranges No.of Air Cond. Teens No.of Alerting Devices
No.of Waste DisposersHeat Pump Number Tons,.__KW_ No.of Self-Contained
Totals:
Detection/Alerti
�n
p allg Devices
No.of Dishwashers Space/Area Heating KW Local 0 Connection
❑�r
No.of Dryers Heating Appliances KW No. f Systems:*
or Equivalent
No.of Water KW
Heaters Signs Ballasts No.of Devices
of No.of Data Wiring:
evices or Erjuivaleut
No.Hydromassage Bathtubs No.of Motors Total HP Tel of ommuni 7 ,_cations Wiring '.d+ `-
No. or Eq'uiVllenY___
OTHER:
co Attach additional detail if desired,or as re tre)16y r rea,
Estimated Value of Electrical Work: 2.t(- ' (When required by municipal policy.) '
Work to Start: 2--I 2,12i4- Inspections to be requested in accordance with MEC Rule 10,and t 1 lc K''M E ENT
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of elect,i..al wmi may Issue untws 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 0 BOND 0 OTHER 0 (Specify:)
I certify,under the pains and penalties o perj that the info this application is true and complete.
FIRM NAME:
�(� ��fir( �C�t _ LIC.NO.: �q I s
Licensee:`e,�enterIa_I �M t�le.(i�cense rum,( 1 / Signnatn �� t/yl —" LIC.NO.:
(If g �C,7 c �t'1V <�JL� l�n tt yS. Bus.Tel.No. l�i'.�41}'CrJz2
Address: I [ t r Alt,Tel No.:
'Per M.G.L.c.147,s.57-61,security work requires DepaitnentbfPublic 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 ant the(check one)❑owner 0 owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE:$
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