HomeMy WebLinkAboutBLDE-23-19523 __ 19/23-,435 PM about:blank
t� Commonwealth of Massachusetts •oF' YA:"'
Town of Yarmouth = ' 0 .
ELECTRICAL PERMIT `��� c.
Job Address: 300 BUCK ISLAND R UNIT 20C Unit:
Owner Name: BROWN ALAN J CO N PHYLLI
Owner's Address: 300 BUCK ISLAND R UNIT Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19523
Existing Service Amps/Volts Overhead ❑ Underground 0 No. of Meters:
New Service Amps/Volts Overhead 0 Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Replace existing panel due to water damage.
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 0 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 ❑ No.of Outlets:
No. Energy Storage Systems: KWH Storage Rating: Security System 0 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 ❑ Level 2 0 Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: September 19, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: RAYMOND E LAFLEUR License Number: 16814
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Barnstable, MA, 026301426 Barnstable MA 026301426 Fee Paid: $75.00
Email: permits@rslafleurelectric.com Business Telephone: 508-775-6814
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
SEP1911 " . Co rn wRn'earu+/o////y�
aaaaclauNi}a Official Use Only
BUILDING DEP. •..5`., 2apar(inenf ot. lee Servicee Permit N°. -C--Z�
/' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
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 C R 12.00
(PLEASE PRINT IN INK OR TYPE AL INFORMATTON) Date: 1 C� 1 'G �
City or Town of: To th y
Inspector of Wi es:
By this application the undersigned gives notice of his or her intention to perform!a electrical work described below.
Location(Street&Number) _
Owner or Tenant d 1 t
Owner's Address Telephone No.5 5. 3
Is this permit in conju on with a building permit? Yes ❑ No \ �
Purpose of Building ,c— II (Check Appropriate Box)
Utility Authorization No.
Existing Service f(y) Amps Volts Overhead
New Service ❑ Undgrd� No.of Meters
Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity
Location and Nature proposed El cal Work:' l (_
_k_ tiLI / /i2 A��(1C P_ f X�Sl�n� �� �t 1
/ t�
vi Completion of the following!able may be waived by the Inspector of Wires.
Ut No.of Recessed Luminaires No.of Cell-Soso. `AI f
4 P(Paddle)Fans ° ° Total
No.of Luminaire Outlets No.
KVA i. No.of Hot Tubs Generators KVA
•i: No.of Luminaires Swimming Pool Above In- No.of Emergency Lighting
grnd. U grad. U Battery Units
-,,,,i No.of Receptacle Outlets No.of Oil Burners
FIRE ALARMS lNo.of Zones
No.of Switches No.of Gas Burners No.of Detection and
l No.of Ranges Initiating Devices
No.of Air Cond. Total
Tons
No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Toas 11 r No.of Self-Contained
Totals:I F _._ ._.___._._.._. Detection/Aierlin•Devices
No.of Dishwashers Space/Area Heating KW Local[]Municipal
No.of Dryers Connection Otber
rY Heating Appliances KW Security Systems:*
No.of Water No.of No.of Devices or Equivalent
Heaters No.of Data Wiring:
Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP 'Telecommunications Wiring:
OTHER: No.of Devices or Equivalent
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of lec cal Work:
(When required by municipal policy.)
Work to Start: ' 3 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE CO GE: 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 E BOND 0 OTHER 0 (Specify:)
I FIRM N under the p and pen ties ofperjury,that the information on this app.(' don is true and complete.
Licensee: LIC.NO.: ]�,B 2j/%
ignature • LiC.NO.:
(If applicable,enter exempt"in the license number line.)
Address: Bus.Tel.No... •S•'7-7 -G23,f1
•Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Alt.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 0 owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE:.3
perm;�-3 rS I-a'Oeare/ivc-fi;e ,Corr`