HomeMy WebLinkAboutBLDE-24-138 AM about:blank
��. `��' Commonwealth of Massachusetts oF ' YA
* Town of Yarmouth z 0
ELECTRICAL PERMIT `,, ifi
Job Address: 21 ARLINGTON ST Unit:
Owner Name: KURKER WAYNE TR HYANNIS MARINE SERVICE RLTY TRUST
Owner's Address: 21 ARLINGTON ST Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-24-138
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground ❑ No. of Meters:
Description of Proposed Electrical Installation: Replace transfer switch & general repairs
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: $ 3,000 Work to Start: January 29, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: ROBERT D RUGGERI License Number: 34896
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: BUZZARDS BAY, MA, 025323198 BUZZARDS BAY MA 025323198 Fee Paid: $150.00
Email: robruggeri4@gmail.com Business Telephone: 508-237-7207
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
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Permit No.: Official Use Only
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:40+-- ( Department of Fire Services Occupancy and Fee Checked:
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,__t= - 4 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
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Novi APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
City or Town of: " c,, 'Th k\-, Date: / -- 5 2,9
To the Inspector of Wi s: By this application, the undersigned gives otices of his or her intention to perform the electrical work described below.
Location (Street & Number): 1 W ;Up1/4,4,/ 3 +fee Unit No.: B i i (,o i! vi it 6
Owner or Tenant: Via >yj �,. 1-0 i t''ker Email: WkçffiXcliiiiiiS A/d1nct ,, c O
Owner's Address: . 3i5. /11q • not i a AU Phone No.: SC15 NO qa 20
Is this permit in conjunction wit a building permit? (Check appropriate box) Yes El No NI Permit No.:
Purpose of Building: Utility Authorization No.:
Existing Service: 900 Amps hAO / C Volts Overhead El Underground [X No. of Meters: I
New Service: Amps / Volts Overhead El Underground El No. of Meters:
Description of Proposed Electrical Installation: � `~
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Completion of the following table 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. ❑ 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 Equip ent:
No. of Modules: Roof-Mount ❑ Ground-Mount ❑ Level 1 ❑ Level 2 ❑ Level 3 ❑ 94;:i .n t "'°"`
OTHER:
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Attach additional detail if desired, or as required by the Inspector of Wires. ií JAN5Work:
Estimated Value of Electrical 0 00
�� (When required b mici al policy)-� p p Y) �
4 F
Date Work to Start: /~ Al--1 Inspections to be requested in accordance with MEC i*,riif eton.
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FIRM NAME:
g),,, „, ;s a( i l A- 1 ID or C-1 El LIC. o.: -----------------
Master/Systems Licensee: LIC. No.:
Journeyman Licensee: R1- 120(o. (re- ( 't LIC. No.: -,`:-/ '6%)
Security System Business requires a Division of Occupational Licensure "S" LIC. S-LIC. No.:
Address: •
Email: Telephone No.:
I certify, under the pains and penalties of perjwy, that the infor tion on is application is true and complete.
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Licensee: Clg), Chi,--(' I `-INSURAN Print Name: � Cell. No.: 503 -.��7�-�7�� 7CE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee
provides proof of liability including "completed operation" coverage or its substantial equivalent. The undersigned certifies
is in force and has exhibited proof of same to the permit issuing office. g that such coverage
CHECK ONE: INSURANCEX BOND El OTHER El Specify:
p fy:
OWNER'S INSURANC
E WAIVER: I am aware that the Licensee does not have the liabilityinsurance coverage
required by law. By my signature below, I herebywaive this requirement. normally
I am the: (Check one) Owner ❑ Owner's agent ❑
Owner / Agent: Tel. No.:
Signature:
Email.: fob ro_39c�' i
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