HomeMy WebLinkAboutBLDE-23-18939 6/15/23, 1:38 PM about:blank
Commonwealth of Massachusetts of:Y,4 ,
*a Town of Yarmouth poi, C
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ELECTRICAL PERMIT
Job Address: 864 &878 ROUTE 28 Unit:
Owner Name: YARMOUTH COUNTRY CABINS LLC
Owner's Address: 67 BAKER ST Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-18939
Existing Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Repairs or additions to#18, 14, 12, 8, 3, 2, 5, 24, &20.
No.of Receptacle Outlets: No.of Switches: Generator KW Rating: Type:
No.Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Ratin Q
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Tdta(
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: �j
No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices: ,✓
No.Air Conditioners: Total Tons: Telecom System ❑ No.of Outlets:
,7
No.Energy Storage Systems: KWH Storage Rating: Security System ❑ No.of Devices: .ti;;; _,..
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment:
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No.of Modules: Roof-Mount Cl Ground-Mount❑ Level 1 0 Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: June 15, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: DANIEL H LAX License Number: 14305
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: BELMONT, MA, 024782838 BELMONT MA 024782838 Fee Paid: $250.00
Email: danhlax@gmail.com Business Telephone: 617-504-5606
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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ILI, Comnwnwaatth o/r/taeaac�uaelle Official Use Only '
k . ..,, cc77 Permit No.
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(, f Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
L,'C) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to he performed in accordance with the Massachusetts Electrical Code(MEC),51 CMR 12.00
_
.J (PLEASE PRINT IN INK OR TYPE ALL INFORM4 TION) Date: fv/'�' i
t4 City or Town of: rcCay/4— To the Inspector of Wires:
Z By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
ck Location(Street&Number) e/ "i/)/,f,/ sr
Owner or Tenant 61,-c..710( /):'li 0 6 ivA// Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes Q No ❑ (Check Appropriate Box)
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Purpose of Building �,','1f'Vic- Utility Authorization No.
Existing Service Amps / Volts Overhead El Undgrd No.of Meters
a New Service Amps / Volts Overhead U Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: ON/!s z 2 3, yt 5 ,', /5 o-( /CI :V'f` 'le-5 .a':'
• c 7 Gi/lr jjv,. Ly. ckii.ye ,Ceeeask 7a oil/ gr/r✓/ 30 IT. Liu,41 rS'4:L'//ems
Pc 4 Completion olhe followingjable may be waived by the Inspector of Wires.
tit No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total
Transformers KVA
CA No.of Luminaire Outlets No.of Hot Tubs Generators KVA
A ve n- No.of Emergency Lighting
No.of Luminaires 6 Swimming Pool }lrnd. grad. Battery Units
No.of Receptacle Outlets If No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners -No.of Detection and
K, Initiating Devices
1 ti Total
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons +1'W No.of Self-Contained
Totals: _ Detection/Alertin Devices
No.of Dishwashers Space/Area Heating KW Local❑ Munidp 0 Other
Connertian4
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
Na.of Water No.of No.of Data Wiring:
Heaters KW Signs Ballasts No.of Devices or Equivalent
No.H dromassa a Bathtubs No.of Motors Total HP 'feleco of Deviations Wiring
y g No.of Devices or Equivalent
!OTHER: CAech. Gi�i ;A) , .443 13/at'rs o--' c�-c>4.teS ;•vri-1;.- /ry/ is 301
[,{ S-, Attach additional detail if desired,or as required by the Inspector of Wires.
2
Estimated Value ofElectrical Work: O (When required by municipal policy.)
Work to Start: > % Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE C VERAGE: 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 cov5rage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE IE BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: l7/'/✓/6t- //. .-/-)>< LIC.NO.: /#3!r 5- #9
Licensee: ,r9/U/c-e L. if: Z./4k Signature � (9/,‘,..-7C— LAC.NO.: 2-1$eS 7 f—
Ilfapplicable,enter"exempt"in the licen a num r line.) Bus.Tel.No.: '/ 7 S9 j'-,.*;.0 6
Address: 2 Z SAL-C/6%1 8e/.T t" / '. -4' 7�j 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:$
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