HomeMy WebLinkAboutBLDE-24-358 3/4/24,2:16 PM about:blank
Commonwealth of Massachusetts -oF • y-4 .
It Town of Yarmouth zoe
ELECTRICAL PERMIT 04
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Job Address: 1077 ROUTE 28 Unit: 1/4.:32 �SONSZ..---c-Tpt-upAN)f
Owner Name: ,4MU1=- RYA
Owner's Address: 1077 ROUTE 28 Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-24-358
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
Description of Proposed Electrical Installation: New bar& install sub panel
No.of Receptacle Outlets: 12 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: $ 1 Work to Start: March 4, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: EDWARD M LYNCH License Number: 35609
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: WEST YARMOUTH, MA, 026733818 WEST YARMOUTH MA
026733818 Fee Paid: $100.00
Email: pinchcalllynch@icloud.com Business Telephone: 774-208-8338
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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Commonwealth of Massachusetts Official Use Onl
I Permit No -3 SVp
-,,,, r Department of Fire Services Occupancy and Fee Checked:
C el BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
� '`-v.1' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 5 C R 12.00
City or Town of: YARMOUTH_ • Date:
To the Inspector of Wires:By this application,t undersigne ryes notices of his or her intention to perform the elec ica ork described below.
Location(Street&Nupulber): Q Unit No.:
Owner or Tenant: fog/. 4 C Email:
Owner's Address: Phone No.:
Is this permit in conjunctn wi� �ldinmit?(Check appropriate box) Yes❑ No ❑ Permit No.:
Purpose of Building: if
eS Utility Authorization No.:
Existing Service: Amps / Volts Overhead❑ Underground❑ No. of Meters:
New Service: Amps / Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: i,(r/(e4 4 e ' gar Ti c-f//�-//�,701
4C rr c% 4 5 6 fQ1e-(.
Completion of the following tbble 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. 0 Hot-Tub❑ No.of Self-Contained Detection/Alerting Devices:
No. Oil Burners: No.Gas Burners: Video System 0 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 D Ground-Mount 0 Level 1 ❑ Level 2❑ Level 3 ❑ Rating:
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electr cal ork: (When required by municipal policy)
Date Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: A-1 ❑ or C-1 ❑ LIC.No.:
Master/Systems Licensee: LIC.No.:
Journeyman Licensee: LIC. No.: 3 c(0.7g
Security System Business requires a Division of Oc ujpiational Licensure" "LIC. S-LIC.No.:
Address: 0`1 J Cog (.� L(/ 0l 1 / o O 73
fEmail: l4 64(/( 4c/( I cto/ ' d riem,l — Telephone No.: 77�- .0W2 Z .27,6%)
I certify,undp the pai s an penalties perjury,that th in ormation on this applicatf on is true and complete.
Licensee:^' Print Name: / 4 Z- WC l Cell.No.:7T �g-9yv
INSURA'CE COVERA U ess waived by the owner,no permit for the perform nce 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 BOND ❑ OTHER El Specify:
OWNER'S INSURANCE W IVER: 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 0
Owner/Agent: Tel.No.:
Signature: Email.: