HomeMy WebLinkAboutBLDE-23-15867 Commonwealth of Massachusetts ..Y .??
* Town of Yarmouth 4'
ELECTRICAL PERMIT ,, ct
Job Address: 10 GILBERT ST Unit:
Owner Name: AMADUCCI PATRICIA D TR AMADUCCI SUZANNE TR
Owner's Address: 3510 VISTA CT Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-15867
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: Septic pump&alarm.
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: 1 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.0 Hot Tub 0 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 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 El Ground-Mount 0 Level 10 Level 2 0 Level 3 0 Rating:
Estimated Value of Electrical Work: $3,600 Work to Start: May 17, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: THOMAS E CUNNINGHAM License Number: 8410
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Dennis, MA, 026382515 Dennis MA 026382515
Email: cunnyelectrical@yahoo.corn Business Telephone: 508-523-0033
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:
0 I e_ K....___
R ECEIVED
O 9 �030 •nwea/th of Massachusetts official Use Only
I. _ �j Permit No.: C(i2`3 — (C(g67
et, e i'artment of Fire Services Occupancy and Fee Checked:
t}i
.� � T RE PREVENTION REGULATIONS [Rev. 1/2023]
*l '=` APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527 R 12.
City or Town of: YARMOUTH Date: ��S/ '/13
To the Inspector of Wires:By this licatio the undersigned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): � j/.g Unit No.:
Owner or Tenant: -./
�4--/ � Email:
Owner's Address: c '1le 4 �' Phone No.: /—Y 2 O
Is this permit in conjunctio with a buildingpermit? Check appropriate box)Yes❑ No❑Permit N.: 3
Purpose of Building: `.. W) ‹ Utility Authorization No.:
Existing Service: Amps / Volts Overhead 0 Underground 0 No.of Meters:
New Service: / Amps/,91 at—A) Volts Overhead Underground 0 No.of Meters:
Description of Proposed Electrical Installation: Wj/ / c 7 P/, t—
PnIZIA-
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 Lumi ices: No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water aters: KW: No.Transformers: Total KVA:
Space Heating KW: Heati Equipment KW: No.Mot rs: Total HP: Total KW:
No.Heat Pumps: Total KW: Total Tons: Fire arm System❑ No.of Devices:
Swimming Pool:In-Grnd.0 Abov -Grnd.❑ Hot-Tub❑ .of Self-Contained Detection/Alerting Devices:
No.Oil Burners: o.Gas Burners: ideo System
No.Air Conditioners: Total Tons: Y El No.of Devices:
Telecom System 0 No.of Outlets:
No.Energy Storage Systems• KWH Storage Rating: SecuritySystem Y stem
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 0 Ground-Mount
OTHER: ❑ Level 1 0 Level 2 0 Level 3 ElRating:
Attach additional detail if desired,or as a uired by the Inspector of Wires.
Estimated Value of Electr al ork �w
��� (When required by municipal policy)
Date Work to Start: Innssp'eJctions to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: Aceve bow S"�
�a A-1 0 or C-1 0 LIC.No.:
Master/Systems Licensee: , V7L ./ //a i% //`�
LIC.No.: 7 4
Journeyman Licensee: L ��V2 7
LIC.No.: S
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address:
Email:
Telephone No.:
I cert ,under pain nd pena es o perjury,that the information this application is true and complete.
Licensee: Print Name: `r��
-7,112
INSURANCE COV RAGE. nless waived by the owner,no permit for the performance of electrical work Cell Nomay issue
tejs��j?
the licensee
provides proof of liability including"completed operation"coverage or its substantial equivalent.The undersigned certifies that ess su such coverage
is in force and has exhibited proof of s to the permit issuing office.
CHECK ONE: INSURANCE BOND❑ OTHER 0 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 0
Owner/Agent:
Tel.No.:
Signature:
Email.: