HomeMy WebLinkAboutBLDE-23-15945 5/2P23, 1:47 PM about:blank
Commonwealth of Massachusetts c - .
Town of Yarmouth
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g£ ELECTRICAL PERMIT
Job Address: 89 NORTH DENNIS RD Unit:
Owner Name: SCOTT MARY E (LIFE EST) C/O MARYELLEN SCOTT
Owner's Address: 174 CHESTNUT FARM WAY Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-15945
Existing Service Amps/Volts Overhead 0 Underground 0 No.of Meters:
New Service Amps/Volts Overhead 0 Underground 0 No.of Meters:
Description of Proposed Electrical Installation: basement finish, replace recessed lights, bring u to code(508-776-5319)
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 0 No.of Devices:
Swimming Pool: In-Grnd.0 Above-Grnd.❑ Hot Tub 0 No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System El No.of Devices:
No.Air Conditioners: Total Tons: Telecom System 0 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: $2,200 Work to Start: May 23, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: MICHAEL D HOLLISTER License Number: 10071
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: 85 North Dennis Rd S YARMOUTH MA 026641017 Fee Paid: $250.00
Email: mikehollisterelectric@hotmail.com Business Telephone: 508-776-5319
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
i, cial Use Only
Department of Fire Services OccuPermit No.: CAE- -
r If=- � BOARD OF FIRE PREVENTION REGULATIONS [Rev.l j2023nd Fee Checked:
]
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527 MR 1 .00
City or Town of: YARMOUTH
To the Inspector of Wires:By the Date: Z. 2.pplication,the undersigned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): 9 �� n-1 l'f► A(t S
R a Unit No.:
Owner or Tenant n�F l//� ,2 yy�}Q, /J i
Owner's Address: c # I- Email:may, o, ,4S�
_2Ir ,7 , C..o
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Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No❑Permit No.:
Purpose of Building: i
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Existing Service: ��� Utility Authorization No.:
Amps / Volts Overhead. Underground 0 No.of Meters: /
New Service: Amps / Volts Overhead❑ Underground
Description of Proposed Electrical Installation: g No.of Meters:
i?��'sLIT Cry is/4-i j2.c19L,ICcG eLF.65:S .,.{3
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Completion of the following table may be waived by the Inspector of Wires.
No.of Receptable Outlets: No.of Switches:
No.Luminaires: No.of Recessed Luminaires: Generator KW Rating: Type:.
No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: KW: No.Transformers:Space Heating KW: Heating Equipment KW: Total KVA:
No.Heat Pumps: Total KW: No.'Motors: Total HP: Total KW:
Total Tons: Fire Alarm System 0 No.of Devices:
Swimming Pool:In-Grad.0 Above-Grnd.0 Hot-Tub
No.Oil Burners: ❑ No.of Self-Contained Detection/Alerting Devices:
No.Gas Burners: Video System No.Air Conditioners: Total Tons: y 0 No.of Devices:
e Systems: Telecom System 0 No.of Outlets:
No.Energy Storage y KWH Storage Rating: Securi S 0
Solar PV KW DC Rating: Solar PV KW AC Rating: ty System
No.of Devices:
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No.of Modules: Roof-Mount 0 Ground-Mount No.of Electric Vehicle Supply Equipment:
OTHER: ❑ Level 1 0 Level 2 0 Level 3 0 Rating:
Attach additional detail rf desired,or as required by the Inspector of Wires
............... .
Estimated Value of Electrical Work:_ 4�
Date Work to Start: (When required by municipal policy)
Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: �rii/'1/4 � ,c�2
Master/Systems Licensee: A-I 0 or C-1 ❑LIC.No.:
Journeyman Licensee: LIC.No.: /��`7 _ r
,� LIC.No.:Security System Business requires a Division of Occupational Licensure"S"LIC. ��D I —
Address: S-LIC.No.:
Email: Mn 1/ 6LST = cr I
e ra t Ca Telephone No.: _07
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I cert ,under the ins and penalties o er ury,that the information on this application is true and complete.
o
Licensee:
INSURAN E Print Name: t(j,�
E' s waived by the owner,no permit for the- performance n 1 "_-----Cell.No.: 2?( ,,�' 3 I e�
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. ectricaI work may issue unless the licensee
CHECK ONE: INSURANCE O
_BOND g
OWNER'S INSURANCE WAIVER: I am aware that the r.ic Specify:
required by law.By my signature below,I hereby waive this requirement.I am the:oes not hav e Check ck o e
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Owner/Agent: ( erl g�t
Tel.No.:Signature:
Email.: II .
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DEPARTMENT