HomeMy WebLinkAboutBLDE-23-19126 7/19/23,3:02 PM about:blank
,tea
Commonwealth of Massachusetts jog•YA '
* Town of Yarmouth ��4. .°`
{
ELECTRICAL PERMIT `�� � �
Job Address: 27 VERNON ST Unit:
Owner Name: KOWALSKI RICHARD R KOWALSKI CATHERINE
Owner's Address: 27 VERNON ST Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19126
Existing Service Amps/Volts Overhead ❑ Underground❑ No.of Meters:
New Service Amps/Volts Overhead 0 Underground ❑ No. of Meters:
Description of Proposed Electrical Installation: Wireless security system
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 ❑ No.of Devices:
No.Air Conditioners: Total Tons: Telecom System ❑ No.of Outlets:
No. Energy Storage Systems: KWH Storage Rating: Security System IS No.of Devices: 1
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: $ 300 Work to Start: July 19, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: STEPHEN B COPPOLA License Number: 1471
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number: SSCO-001351
Address: GROVELAND, MA, 018341007 GROVELAND MA 018341007 Fee Paid: $45.00
Email: businesspermits@vivint.com Business Telephone: 877-479-1667
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:
gt,c s d_,_
1/1
about:blank
R +CID
_* - 1 1 9 2023 rnm'nwealtsh a/Maaiachu6etf3 Official Use Only
trpy j
(r t- cc-� Permit No.
tINC ? h R1_T A e*zrtment of Jire�ervicee
BOARD OF FJRE=PREVENTION REGULATIONS Occupancy and Fee Checked
�, [Rev. 1/07]
(leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:
City or Town of: West Yarmouth To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number)27 Vernon St
Owner or Tenant Catherine Kowalski Telephone No. (781) 540-1443
Owner's Address 27 Vernon St
Is this permit in conjunction with a building permit? Yes ❑ No Z (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead E Undgrd❑ No.of Meters
New Service Amps / Volts Overhead n Undgrd❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Low voltage wireless burglar alarm installation
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Above In- ❑ No.of Emergency Lighting
No.of Luminaires Swimming Pool
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners I FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
Total1
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons ,KW No.of Self-Contained
Totals: "'" Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW 1 Local 0 Municipal Other
Connection Ill
No.of Dryers Heating Appliances KW 'Security Systems:*
No.of Devices or Equivalent
No.of Water No.of No.of
KW
Heaters Data Wiring:
Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:businesspermits@vivint.com
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: $300 (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
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.
CHECK ONE: INSURANCE ® BOND 0 OTHER 0(Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Vivint Inc LIC.NO.: 1471
Licensee: Stephen Coppola Signature LIC.NO.: 1471
(If applicable,enter"exempt"in the license number line) �'Z—" Bus.Tel.No.:877479-1667
Address:493I N 300 W Provo, UT 84604 Alt.Tel.No.:.877-479-1667
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. 001351
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 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$45