HomeMy WebLinkAboutBLDE-23-15992 6/5/23,3:32 PM about:blank
Commonwealth of Massachusetts ov VA`
Town of Yarmouth
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ELECTRICAL PERMIT ���'
Job Address: 200 UNION ST Unit:
Owner Name: WILLIAMS JONATHAN D
Owner's Address: 200 UNION ST Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number:BLDE- -15992
Existing Service Amps/Volts Overhead ❑ Underground ❑ • No. of Meters:
New Service Amps/Volts Overhead❑ Underground 0 *'�r, No.of Meters:., C35!
Description of Proposed Electrical Installation: Basement finish
No.of Receptacle Outlets: 13 No.of Switches: 1 Generator KW Rating: Type: . ,17 .‘
No.Luminaires: No.of Recessed Luminaires: 14 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 0 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 0 Level 1 0 Level 2 0 Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1,200 Work to Start: June 5, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: License Number:
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Fee Paid: $250.00
Email: Business Telephone:
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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RECEIVED /9e'&J
J U N 05 202„0»{ .a 0/Kmach. tt.6 Official Use Only
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Permit No. 3 -(S`?c1-7 "
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Occupancy and Fee Checked
V /,, : a , - a • - "REVENTION REGULATIONS kRev, 1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC). 27 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: &11-j/ 3
C. City or Town of: ittityloa ti To the Inspect r of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
�' Location(Street&Number) 0 0 ten/clil S
,• J Owner or Tenant �f v)a_'-.ifs O. L- Jdh-c,,.vi A Telephone No. 3C 2-3 -71-/
Owner's Address 24cr, LAIIeryt St 671,00?0zd-A 410(7; P9/9 026
- Is this permit in conjunction with a building permit? Yes No E (Check Appropriate Box)
Purpose of Building I-- —.6it71ycc/ Utility Authorization No.
Existing Service • Amps /Z)/ZyL\ Volts Overhead Ere Undgrd C No.of Meters ()
' New Service Amps / Volts Overhead❑ Undgrd No.of Meters
y Number of Feeders and Ampacity
111 Location and Nature of Proposed Electrical Work: X 64,0 t„f 67-7jt S A
Completion of thefollowin&table may be waived by the!ns ectar of Wires.
Total
No.of Recessed Luminaires ,/5' No.of Ceil.-Sasp.(Paddle)Fans Trrano KVA
No
f KVA
sformers
't No.of Luminaire Outlets No.of Hot Tubs Generators KVA
- No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd Battery Units
No.of Receptacle Outlets /3 No.of Oil Burners FIRE ALARMS No.of Zones
�" No.of Switches 2. No.of Gas Burners No.of Detection and
Initiating Devices
f 1,f No.of RangesNo.of Air Cond. Total No.of AlertingDevices
Tons
No.of Waste Disposers Heat Pump Number Tons KW 4No.of Self-Contained
Totals: . _ Detection/AlertintDevices '
No.of Dishwashers Space/Area Heating KW Local 0 Municineckpaalbn 0 SysteCon
No.of Dryers Heating Appliances KW Security Na.of Devices
ces or Equivalent
'No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications hiss
No.of Devices or Equivalent
OTHER:
c.'' Attach additional detail if desired,or as required by the inspector of Wires.
Estimated Value of Electrical Work: / ,i 2 U(.,) - (When required by municipal policy.)
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Work to Start:(c,, t-1Cc p 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 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 of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:
Licensee: Signature LIC.NO.:
(If applicable,enter"exempt'in the license number line.) Bus.Tel.No.'
Address: Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public 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)❑owner ❑owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$