HomeMy WebLinkAboutBLDE-23-18976 € 1/2.3,6:59AM about:blank
• Commonwealth of Massachusetts o Y-4
* _ Town of Yarmouthif
ELECTRICAL PERMIT
Job Address: 4 PERCH POND WAY Unit:
Owner Name: NENNA FRANCES L(LIFE EST)
Owner's Address: 4 PERCH POND WAY Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-18976
Existing Service Amps/Volts Overhead ❑ Underground❑ No.of Meters:
New Service Amps/Volts Overhead 0 Underground 0 No.of Meters:
Description of Proposed Electrical Installation: Install baseboard heat in sunroom.
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 El No.of Devices:
Swimming Pool: ln-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 ❑ 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 El Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1,900 Work to Start: June 19, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: ADAIR MARTINS License Number: 23369
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: OSTERVILLE, MA, 02655 OSTERVILLE MA 02655 Fee Paid: $75.00
Email: info@mrcapeelectrician.com Business Telephone: 508-301-2655
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 Official use only
Permit No.: i=-L3 -( i�I ,4.
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L.=* '7�,= / Department of Fire Services Occupancy and Fee Checked:
—,_el " BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
yl .- APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
City or Town of: YARMOUTH Date: j2.0 f 2.3
To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): 4-- ix.r.di. feel i W Unit No.:
Owner or Tenant: Fracas(p 1,_,f, NeA no% Email: In qv e IYl rr°c p#; Je C} i c:icvt. ,r {y�
Owner's Address: Phone No.: I
Is this permit in conjunction with a building permit?(Check appropriate box)Yes 0 No❑Permit No.:
Purpose of Building: Utility Authorization No.:
Existing Service: Amps / Volts Overhead❑ Underground❑ No. of Meters:
New Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:Description of Proposed Electrical Installation: i,‘)i.N I d 14 S1 /l e - f—
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Math{-ex ;Yl S /n 1 004 t
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 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 0 Ground-Mount❑ Level 1 0 Level 2 0 Level 3❑ Rating:
OTHER:
Attach additional detail if desired,or as reeked by the Inspector of Wires.
Estimated Value of Electripal Wi rk:4 l 1 0 t) (When required by municipal policy)
Date Work to Start: 06/1 Gt /2 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: it4 2 .( 1 e..th it 'thy, l_L.(. A-1 0 or C-1 0 LIC.No.:
Master/Systems Licensee: (jail r M.AA- n S .-- . f LIC.No.: 2 3 3 6 Cj 4
Journeyman Licensee: . /; I v(r ct,c -yr1,c. j rt- LIC.No.: 5 j 6 $3 j
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: !
Address: a 770 (.U(Yl ni c�n�c of.6701 1/V 41 2,41 Hi ici.4 n S CCU M 4- 0Z I
Email: facoU Q Ili cc Otie. CILc t-nc.;oi-.0 s Cy) . TelephoneNo.: SO 30) - Z.6C5
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
Licensee: , Print Name: 44 4, AA.,..r- /71l S Cell.No.: 5-0S--8/3"-4.1 9.-3
INSURAN E COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee
provides proof of liability including"comp ted operation"coverage or its substantial equivalent.The undersigned certifies that such coverage
is in force and has exhibited proof of s to the permit issuing office.
CHECK ONE: INSURANCE BOND❑ OTHER❑ Specify:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law my signatar 4 by waive this requirement. I am the:(Check one)Owner❑ Owner's agent❑
Owner/Agent: - ; V D Tel.No.:
Signature: ` Email.:
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