HomeMy WebLinkAboutBLDE-23-18936 6/14/21 3:45 PM � `^ about:blank
.41NCommonwealth of Massachusetts -.0
* Town of Yarmouth
ELECTRICAL PERMIT
Job Address: 230 WINSLOW GRAY RD Unit:
Owner Name: HAYES TERENCE M
Owner's Address: 230 WINSLOW GRAY RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-18936
Existing Service Amps/Volts Overhead 0 Underground 0 No. of Meters:
New Service Amps/Volts Overhead❑ Underground 0 No.of Meters:
Description of Proposed Electrical Installation: Replace service cable & meter socket. (W/O# 13426363) e f 1646 ;G
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: ln-Grnd.❑ Above-Grnd.0 Hot Tub 0 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 0 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 0 Level 1 El Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1,000 Work to Start: June 15, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: ROBERT GREER License Number: 22539
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Marstons Mills, MA, 026481841 Marstons Mills MA 026481841 Fee Paid: $50.00
Email: robertgreer87@gmail.com Business Telephone: 508-221-5350
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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UN 14 2LQmkncnwealth of Massachusetts Official Use Only
It= ,1� ?' Department of Fire Services OcPecupancy n y andFee Checked:
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i� F YlFRE PREVENTION REGULATIONS [Rev. 1/2023]
'`'-'''4 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527.cm 12.00
City or Town of: YARMOUTH Date: C'/i .2c .2 .3
To the Inspector of Wires:By pis a plication,the,undersigned gives otices of his or her intention to perform the electrical work described below.
Location(Street&N ber):.� ,0 Li 1✓I S/0LI u-'-v.t'y i ,, Unit No.:
Owner or Tenant: l ere p)c e / c-1 s Email: (�
Owner's Address: S e---,,,,e Phone No.: ,cV d 7 Cv ( qg ,2
Is this permit in conjunct with ouilding permit?(Check appropriate box)Yes❑ No Permit No.:
Purpose of Building: vve t(/7 y Utility Authorization No.: ( 31f-1 6 - 4 3
Existing Service: I d9 Amp /2l?/ Volts Overhead,® Underground[2] No.of Meters:_I
New Service: ( d 0 Amps /20 /2 a'Volts Overhead Underground
g 0 7p€ .
No. of Meters: /
. Description of Proposed Electrical Installation: R 2. e__ c�v t'r.e Cot t2(e_ tA-
vvl.C,i-e� Soc e+ p
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 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❑ 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 0 Ground-Mount El Level 1 0 Level 2❑ Level 3 0 Rating:
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of electrical Work: I 000 d (When required by municipal policy)
Date Work to Start: C, (1 t�1 �3 1 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: 1-2jf G i-le^v— A-1 El or C-1 0 LIC.No.:
Master/Systems Licensee: 3 .7 39 A Km G, ,r LIC.No.: 2 c 3 1 /--1
Journeyman Licensee: (ke.-4'6,,2o.e`- LIC.No.: 5r 39-,A <3.
Security System Business requires a Division of Occupational Licensure"S"LIC. S-/ AlLIC.No.:
Address: /4op�M -f
c I nl k P / t' t , S-1a�iS' / 2) Cf5' A 0 64 2
Email: bC',--'CG,--etv c'7 e, r /. (0 G--7 Telephone No.: 5 C)E.2.D (S�6-
I certify,under . s a penalties of perjury,that the information on this application is true and complete.
Licensee: � Print Name: poke,- G ,-- ,Cell.No.: (7g (. y,6
IE _
INSU CE C ERA Unless 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 o s e to the permit issuing office.
CHECK ONE: INSURANCE BOND 0 OTHER 0 Specify:
OWNER'S INSURANCE W IVER: 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.: