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HomeMy WebLinkAboutBLDE-24-445 3/20/24,7:00 AM about:blank Commonwealth of Massachusetts of• Y' �4 * Town of Yarmouth 04, t-c ELECTRICAL PERMIT Job Address: "LONG POND DR Unit: S/ S Owner Name: "-LONG 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 El Underground ❑ No. of Meters: New Service Amps/Volts Overhead ❑ Underground El 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: 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 El 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 0 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: *17-4-1 about:blank 1/1 ``rr v-`�— g - 22 1 . sZ, Commanai.ah 0////addachadette Official Use Permit No.• s ' w� 2epartmeni al7ir.Serviced BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Rev.lro7] (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 (PLEASE PRINT IN INK OR TYPE ALLINFORMAT7ON) Date: 2-2 a-2.4 City or Town of: Yar 1T'\(`-u-v-`-1 To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electricaly .w�ork described below. �y Location(Street&Number), IF..) IC `f C>► 1 C , (n, tom- r rrv'-t1 1.r r 1`, Owner or Tenant ,c-�-")r) c ` ) Telephone No. Owner's Address ''11 I Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility, Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampaclty Location and Nature of Proposed Electrical Work: run ca rlc"\N . �mY-. Neill-- VI Completion of the following table m% To be waived by the/nsnectortal of Wires. LbNo.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Ce Transformers KVA CiNo.of Luminaire Outlets No.of Hot Tubs Generators KVA t No.of Luminaires Swimming Pool Above ❑ In- 0 No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones F No.of Switches No.of Gas Barmen No,of Detection and Initiating Devices I U No.of Ranges No.of Alr Coed. m No.of Alerting Devices No.of Waste Disposers Heat Pump Number[Tees KW 'No.of Self-Contained Totals: Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local❑Monnection unicipal El Other C No.of Dryers Heating Appliances KW Security Systems:* evices or Equivalent No.of Water No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Eguiyalent Telecommunications Wiring No.Hydromassage Bathtubs No.of Motors Total HP No.of Drier or Equivllent OTHER: y�,p )�,,y Attach additionsl detail if desired,or at regrrbipd r''a19R'res. Estimated Value o Electrical''W1ork: 2_,CC© (When required by municipal policy.) Work to Start:Zfi ZR 1ZLt Inspections to be requested in accordance with MEC Rule 10,and*dhl-dtf.'`N'M E N T j INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of elec J 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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties o perjure' that the info this application is true and complete. _ FIRM NAME: t. RA o") i.I F ._----- LIC.NO.: 0,I d Licensee: Il l s.ti n T - Signatu (-`----- LIC.NO.: (ljapplicable,enter" _,ln� ,.lke uj number li / Bus.Tel.No..1&1',.2) -C5 22. Address: I g i ^C c7 �Y1 c� � II ,_ rl,l l� % • Alt.Tel.No.: *Per M.G.L.c.147,s.57-61,security work requires DepartmenlbftPttblic 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 am the(check one)0 owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ �i • • . .• • • • ilSoS 6-ft 71011 • • •