HomeMy WebLinkAboutBLDE-23-18885 -,13/2: .:47 AM about:blank
Commonwealth of Massachusetts ov rvYAix
* Town of Yarmouth
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ELECTRICAL PERMIT 'cc. -fr
Job Address: 126 MID-TECH DR Unit: ..)K..1 --t o T IL,-4' P(20 S 7 C le—
Owner
Name: MACENERNEY LANCE A TR LANCE A MACENERNEY TRUST
Owner's Address: 126 MID-TECH DR Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-18885
Existing Service Amps/Volts Overhead ❑ Underground 0 No.of Meters:
New Service Amps/Volts Overhead 0 Underground 0 No.of Meters:
Description of Proposed Electrical Installation: Upgrade lighting (Orthotic&Prosthetic)
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 KV
Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total K C
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No. Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of Devices: ' �
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Swimming Pool: ln-Grnd.0 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 El No.of Outlets:
No. Energy Storage Systems: KWH Storage Rating: Security System El No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment:
No.of Modules: Roof-Mount 0 Ground-Mount 0 Level 1 0 Level 2 0 Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: June 7, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: RAUL R BATALLAS License Number: 20262
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Westminster, MA, 014731212 Westminster MA 014731212 Fee Paid: $80.00
Email: raulbatallaselectric@verizon.net Business Telephone: 978-400-5291
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 Only.,
Permit No.: 2-3 —( G5
' > - 5t Department of Fire Services Occupancy and Fee Checked:
-;;.„-Asir,_.; a BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
F.''`=-34' 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: to roviergc-fet_ Date: (ol'I/A 3
To the Inspector of Wires: By tplication.the undersigned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): /AG Mid Teel/ i7R/lk. Unit No.:
Owner or Tenant: ORtflaf e. G1'.itd Peasihtfie_. Email:
Owner's Address: Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes El No(,Permit No.:
Purpose of Building: Utility Authorization No.:
Existing Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:
New Service: Amps / Volts Overhead ElUnderground❑ No. of Meters:
Description of Proposed Electrical Installation: .Z,Shu/l iXt it) (4-L) j i j•x p,-
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.0 Hot-Tub 0 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 0 Ground-Mount 0 Level 1 0 Level 2 ❑ Level 3 ❑ Rating:
OTHER:
Attach additional detail if desired,or as required by th,c Inspector of Wires.
Estimated Value of Electrical Work: /j G92. �" (When required by municipal policy)
Date Work to Start: QQ10//7/�R 3 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: ,C✓a�R//(SEkehlit I A-1 igt or C-1 ❑ LIC. No.: 001 ill
Master/Systems Licensee: /t eid 64ingt5 LIC.No.: 4O44. of
Journeyman Licensee: t .LL/ $*J//45 LIC.No.: 3 11W e
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC. No.:
Address: 6V/ Otte R4 ��1 idereniiol-o met a oly73
Email: null ha}*I/l 5tleGT?Gi 0 a)flr;1.orl•h,G1F Telephone No.: QFf%ee 90.i/t —mi
I certi , u e in and hies of 9e iu qZ�'le?a•7A�fy p �,rY'_ .f perjury,that the information on this/application is true and cornplete.
Licensee: :,
G Print Name: PQ7G/ ,8�las Cell.No.: Q§'a33''Z4
INSURANCE 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 that such coverage
is in force and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE 01. BOND[:1._OT.) eiy:JUDIX r aed/ wgq f ps
OWNER'S INSURANCE WAIVER: I am tviii iiiairaea.ideiliee,d ' t have the liability insurance coverage normally
required by law.By my signature below,I her , aive this requirement.I the:(Check one)Owner❑ Owner's agent 0
Owner/Agent: I ! JUN 0 8 2023 el.No.:
Signature: L mail.:
BUILDING DEPARTMEN?
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