HomeMy WebLinkAboutBLDE-23-19426 8/31/23, 1:28 PM about:blank
' Commonwealth of Massachusetts o� Ygt,
* *4
1 Town of Yarmouth fr, ,
ELECTRICAL PERMIT '
Job Address: 42 L f S 4- -1 l nI Unit:
Owner Name: �1 `C�
Owner's Address: '�k 11 �`" _ Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19426
Existing Service Amps/Volts Overhead 0 Underground❑ No. of Meters:
New Service Amps/Volts Overhead 0 Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Repairs to overhead service done by excavator.
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 O 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❑ Ground-Mount❑ Level 1 ❑ Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: August 31, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: TIMOTHY W MCINTYRE License Number: 31437
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: TEATICKET, MA, 025362428 TEATICKET MA 025362428 Fee Paid: $50.00
Email: timothymcintyre21@yahoo.com Business Telephone: 774-836-8426
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:
&\t" 6- (ii,(9;S -c_.--
NCI:TM-'t -- 22-63 i Y3 2--
7. n
about:blank
1/1
RECEIVED .
°�+ UG 31 2n? o onwealth of Massachusetts
*•�� �� DEPARTME Official Use ly
e•artment of Fire Services Permit No.: —, r
�� - Occupancy and Fee Checked:'IRE PREVENTION REGULATIONS [Rev. 1/2023]
`—` APPLICATION FOR PERMIT TO PERFORM ELECTRICAL
All work to be performed in accordance with the Massachusetts Electrical Code(MEC), S WORK
City or Town of: YARMOUTH _ 12.00
To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to performa the electrical work described
Location(Street&Number): below.
Owner or Tenant: �/ •; r Unit No.:
Owner's Address: � Email•
Is this permit in conjunction with a building permit?(Check appropriate box)Yes No❑Permit No.:
Purpose of Building:_ I��,.1 f •/ _J yei
Existing Service: c� Amps Utility Authorization No.:
New Service: p ��c' /� Volts Overhead❑ lignder round
Amps / Volts Overhead El Underground El No. of Meters:�-
Description of Proposed Electrical Installation: No.of Meters:
r �• �- UvN^% l 1i�,��r f a.
• 4 KcC t
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: 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
No.Oil Burners: ❑ No.of Self-Contained Detection/Alerting Devices:
No.Gas Burners: Video System
No.Air Conditioners: Total Tons: ❑ No.of Devices:
Systems: Telecom System 0 No.of Outlets:
No.Energy StorageKWH Storage Y Rating: SecuritySystem
Solar PV KW DC Rating: y 0 No.of Devices:
Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment:
No.of Modules: Roof-Mount 0 Ground-Mount 0 Level 1pp e
OTHER: 0 Level 2 0 Level 0 Rating:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: /6/ , C'°'
Date Work to Start: s;'_ ;� _ _ (When required by municipal policy)
Inspections to be requested in accordance with MEC Rule 10,and upon completion.
• FIRM NAME: %�,, 1� �
c .rr �a f,c,
Master/Systems Licensee: A-1 ❑or C-1 ❑LIC.No.:_
_� LIC.No.:Journeyman Licensee:
c - il
Security System Business requires a Division of Occupational Licensure"S"LIC. LIC. No.: F" — /�/ ��
Address: POS-LIC.No.:
Email: `>L,--pici-V-4 14-1 c_:ti.-/-
----._ .2/ I l oa, c_c),-,-; Telephone No.: 2 5,—R3
I certify,und he pains and pen .fP Jry,s o er'u ,that the information on this application is true and complets
Licensee: ��'v�
INSU Print Name: , 744 ( `
CE COVERAGE: Unless waived by the owner,no permit for a performance of electrical work may issue unless the licensee
provides proof of liability including"completed operation"coverage or its substantial equivalent.The undersigned »� �� �`���
is in force and has exhibited proof of same t the permit issuing office.CHECK ONE: INSURANCE O_ certifies that such coverage
OND❑ 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. El Owner's agent El
Owner/Agent:
Signature: Tel.No.:
Email.: