HomeMy WebLinkAboutBLDE-24-521 EXPIRED 4/2/24,F-16 AM about:blank
Commonwealth of Massachusetts
* - Town of Yarmouth
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ELECTRICAL PERMIT ?! .� `
Job Address: 1045 ROUTE 28 Unit:
Owner Name: MULLEN MARY A
Owner's Address: 245 MAIN ST Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-24-521
Existing Service Amps/Volts Overhead 0 Underground ❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Flood lights, sign lights, &switches. (BUCKY'S CONVINIENCE STORE)
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 0 No.of Devices:
No.Air Conditioners: Total Tons: Telecom System ❑ No.of Outlets:
No. Energy Storage Systems: KWH Storage Rating: Security System 0 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: April 1, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: JOHN MARA License Number: 58035
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: WEST YARMOUTH, MA, 02673 WEST YARMOUTH MA 02673 Fee Paid: $80.00
Email: mara.john.r@gmail.com Business Telephone: 339927-7596
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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•IRECEIVED
r ornmonwealth of Massachusetts Oct Iu eon
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_-_ 1 2024 Permit No.:Department of Fire Services Occupancy and Fee Checked:
411— OF FIRE PREVENTION REGULATIONS
�:— [Rev. I/2023
Buy=__�i- . �>BY :N:,,..` -• = — .,ATION 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: y/ i /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): I 0 LA5 +-C., ZS— Unit No.:
Owner or Tenant: B u c /[ Y CO,.)�f `/i/ i &Ai e r Email: 5—'0 8 — 3 6 7 — 8 7-6
Owner's Address: Phone N
Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No aPermit No.:
Purpose of Building: Utility Authorization No.:
Existing Service: Amps / Volts Overhead❑ Underground ❑ No. of Meters:
New Service: Amps / Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: 4 D D / ,X' FX Ten 1 o 2. Ft O 0 D
1../4 H� ADD 6td/rC14f-5 /NTI`/2 /a R / J/a 4 L/4 /�7
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: 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 0 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:
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Elec ical ork: 3 £ (When required by municipal policy)
Date Work to Start:3 .2/ ..2 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: To E1 r) f4 fIAJA rte-r Tn./C A-1 ❑ or C-1 ❑ LIC.No.:
Master/Systems Licensee: LIC. No.:
Journeyman Licensee: TO N iU M R IL A LIC. No.: 38 b 3 S 8
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC. No.:
Address: /( 7/Ai E(.4)O o, RD to. 2
Email: Ai R iz/q . ,Ja y,v . AZ 4 ,v &i / . cd iv) No.: 33 / 02 73—c/
I certify, under the pains and penalties of perjury, that the information on this application is true and cornplei
Licensee: Print Name: TO Nn/ M A/L A Cell. No.: ,S
INSUR E COVERAG . ess 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 sa o 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❑ Owner's agent❑
Owner/Agent: _ Tel.No.:
Signature: Email.:
s/lA