HomeMy WebLinkAboutBLDE-23-20094- 12/30/23, 10:31 AM about:blank
Commonwealth of Massachusetts of ' YR4
*v '' Town of Yarmouth
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ELECTRICAL PERMIT
Job Address: 64 KINGS CIRCUIT Unit:
Owner Name: GREEN COMPANY INC
Owner's Address: 46 GLEN AVE Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-20094
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground Cl No. of Meters:
Description of Proposed Electrical Installation: Install additional circuits in kitchen
No.of Receptacle Outlets: No.of Switches: Generator KW Rating: Type:
No. Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind Aliating:
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: a, Total KVA;j
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: y(�
Swimming Pool: In-Grnd.❑ Above-Grnd.❑ Hot Tub I: 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: 7A Afie
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: $ 1 Work to Start: January 5, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: EDWARD M LYNCH License Number: 35609
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: WEST YARMOUTH, MA, 026733818 WEST YARMOUTH MA
026733818 Fee Paid: $80.00
Email: pinchcalllynch@icloud.com Business Telephone: 774-208-8338
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
I=�3 _z.EtY39
Permit No.:
I �i=9t Department of Fire Services Occupancy and Fee Checked:
. BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
%"-`�` APPLICATION FOR PERMIT TO PERFORM ELECTRICA WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527 1 .00
City or Town of: YARMOUTH _ • Date:
To the Inspector of Wires:By this)p I heat' n,the undersii ned gives notices f his or her intention to perform the electrical ork des ribed below.
Location(Street&Number): 6 1 /4 ' l_f (1r T' Unit No.:
Owner or Tenant: 1-R41 5 ti/et t
/ci 7 7 Email:
Owner's Address: / Phone No.:
Is this permit in conjunc n wt a building p rmit? heck a pr ri box)Yes❑ No ❑ Permit No.:
Purpose of Building: S at •- d �t0 Utility Authorization No.:
Existing Service: Amps / o s r i d❑ Underground❑ No. of Meters:
New Service: Amps / Volts Overhead❑ Underground❑ No. of eters:
Description of Proposed Electrical Installation: t '^
, t -
Completion of the following table may be waived by the Insp for 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 IIP: Total KW:R E C E I V c D
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 De\iceDEC 2 9 2023
No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices:
No.Air Conditioners: Total Tons: Telecom System 0 No.of Outlets:BU1[Dl N� )F PARTM:NT
No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of Deviesi
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 I ❑ Level 2❑ Level 3 0 Rating:
OTHER:
Attach additional detail if desi ed, or as required by the Inspector of Wires.
Estimated Value of Elec teal ork: (When required by municipal policy)
Date Work to Start: j 2--9- Inspections to be requested in accordance with MEC Rule 10, and upon completion.
FIRM NAME: A-1 ❑ or C-1 0 LIC.No.:
Master/Systems Licensee: / LIC.No.:
Journeyman Licensee: 4�Td tile 4 LIC.No.: 3 c6'0,9
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: W q - Wi 2 U- peo yl/ 11,11(1 7 t, 2-6 7 3
Email: 146 Cq /C ® G(0(4. r (SOW _ Telephone No.: ?7 -, �" r919
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I certify,and he pains d ena 'es of rjury, that the in o motion on this applicatii n is true and complete. �f >
Licensee: I rint Name: (ilf G �1C!'' Cell.No.: 77 O ^��7
INSURANCE COVERAGE: Un ess aived by the owner,no permit for the performat'�ce 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 me to the permit issuing office.
CHECK ONE: INSURANCE BOND ❑ OTHER❑ Specify:
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: Tel.No.:
Signature: Email.:
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