HomeMy WebLinkAboutBLDE-24-177 1:29 PM e?- about:blank
�CC7 O Commonwealth of Massachusetts .o za
* Town of Yarmouth °kt* `
ELECTRICAL PERMIT: (1'
Job Address: 1376 BRIDGE ST UNIT 19 Unit: 1
161 lr 4(011 I
Owner Name: MAZZ 5 LLC
Owner's Address: 119 ROUTE 149 Phone: Email:
Purpose of
Building Residential Utility Authorization No.: 1
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-24-177
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Remodel condo
No.of Receptacle Outlets: 20 No.of Switches: 10 Generator KW Rating: Type:
No.Luminaires: 5 No.of Recessed Luminaires: 20 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: 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 ❑ No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment:
No.of Modules: Roof-Mount O Ground-Mount❑ Level 1 ❑ Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 5,000 Work to Start: February 5, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: BRAD J CAMPBELL License Number: 35550
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: MARSTONS MLS, MA, 026481128 MARSTONS MLS MA
026481128 Fee Paid: $180.00
Email: bradcampbellelectric@icloud.com Business Telephone: 508-776-0184
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 Us only
t Permit No.: .�Z �
r�-.'III_Bt Department of Fire Services Occupancy and Fee Checked:
•,— f-- BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
"°-.-.6` 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: YARMOUTH _ Date: / 7 2 V
To the Inspector of Wires: By this application,the undersigned gives notices of his or her intention to perform the electrical work described below.
: (Location(Street&Number . ,j . to/4 i", 5% 13/.S. e(VU Unit No.:
Owner or Tenant: zFv i �`-Z.zu l Email: L:N i r �l
Owner's Address: �j C(1( , Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No ❑ Permit No.:
Purpose of Building: ,,,e 1( t""sc l Cc,rCX e7 Utility Authorization No.: 2
Existing Service: ,Au'tps)Ad/ e(C2Volts Overhead❑ Undergrounds] No. of Meters:
New Service: Amps / Volts Overhead ElUnderground❑ No. of Meters:
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Description of Proposed Electrical Installation: Moue lec+ f‘ . Sir v/CC � (C j i2 6u4e ST,'Ct
(A)tr-e ( 4erg<< 1 of C V4 v nCttt(14bOU )
Completion of the following table may be waived by the Inspector of Wires.
No.of Receptable Outlets: "2!7 No.of Switches: / V Generator KW Rating: Type:
No.Luminaires: No.of Recessed Luminaires: Z-6 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:In-Grnd.❑ Above-Grnd. ❑ Hot-Tub❑ No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices:
No.Air Conditioners: Total Tons: Telecom System 0 No.of Cuts '
FD
No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of lieu Ce,. .... V _.__
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipticteni No.of Modules: Roof-Mount❑ Ground-Mount Level I 0 Level 2 ElLevel 3 0 Rating: 1 n 2Un
24
OTHER:
L
BUILDING pbPART MENT
Attach additional detail if desired, or as required the Inspector of Wires. By —____.
Estimated Value of Electrical Work: 5. 0.60 ••— (When required by municipal policy)
Date Work to Start: / •n/S-2 ( tr Inspections to be requested in accordance with MEC Rule 10, and upon completion.
FIRM NAME: Fd4dl ea/(,(6p se(1 y 6(e ‘-']/I C/�� A-1 ❑ or C-1 ❑ LIC.No.:
Master/Systems Licensee: U LIC.No.:
Journeyman Licensee: krej `Cci,Iu e b e (( LIC.No.: E S`S 5 0
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: ?L/^) 101-. /�f ✓<ek g / , 1 `"'l4; "" AI X 1`l6j C3 GZ�c-
Email: I p ry j('c.1 *ADC()e 40 1e e V�t CC I< )��: C ci Telephone No.:
I certify,under t e pains and penal( s f perjury,that the information on this applicati/ n is true and complete.
Licensee: �� Print Name: 'Bp4.G st,(� r'J-t' , 7
Cell.No.: 774 1 �/
INSURAN COY/ RAGE: nles 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❑ 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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