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Commonwealth of Massachusetts wog 4
* Town of Yarmouth � r
i O y
ELECTRICAL PERMIT
Job Address: 40 BLUE ROCK RD Unit:
Owner Name: KEARNEY PATRICK J BENEDETTO STACEY
Owner's Address: 40 BLUE ROCK RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.: 14296581
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19428
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: Replace meter socket to a meter main
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: In-Grnd.❑ 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 ❑ 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:
Estimated Value of Electrical Work: $ 1,500 Work to Start: September 1, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: STEVEN J PEREIRA License Number: 10286
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Lincoln, RI, 028654308 Lincoln RI 028654308 Fee Paid: $50.00
Email: Sjpereira@yahoo.com Business Telephone:491-644-7250
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:
iii__Si 91 2412,3 116
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