HomeMy WebLinkAboutBLDE-23-19758 10N(23.218 PM about:blank
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41, e Commonwealth of Massachusetts of • Y�4.
Town of Yarmouth ,° h .,c
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ELECTRICAL PERMIT `" . y.
Job Address: 78 WEIR RD Unit:
Owner Name: EMMANUEL JUNIOR SOUVERAIN ALTAGRACE KS
Owner's Address: 78 WEIR RD Phone: Email:
Purpose of Utility Authorization No.:
Building Residential
Permit Number: BLDE-23-19758
Is this permit in conjunction with a building permit? Yes PermNo. of Meters:
Existing Service Amps/Volts Overhead ❑ Underground 0
New Service Amps/Volts
Overhead 0 Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Remove unpermitted work in basement
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❑ No.of Self-Contained Detection/Alerting Devices:
System ❑ No.of Devices:
No.Oil Burners: No.Gas.Burners: Video S y
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 Li Level 1 ❑ Level 2 0 Level 3❑ Rating:
Estimated Value of Electrical Work: $ 11 Work to Start: October 30, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: ROBERT A SOUSA License Number: 40596
Security System Business requires a Division of Occupational Licensure License Number:
"S" LIC.
Address: Osterville, MA, 026550014 Osterville MA 026550014 Fee Paid: $250.00
Email: robertsousa34@gmail.com Business Telephone: 508-420-0785
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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[RECEIVED a6F7 $;;?So u
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-! 1 3 1 L, I Permit No.: C 2-3 --t ,
>�1=_ ' D�pcarrtment of Fire Services Occupancy and Fee Checked:
1.%, =31 v BOARD IOFkfFI , E PREVENTION REGULATIONS [Rev. 1/2023]
y`'. 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: j O-30 23
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): U C7 CA_ R D Unit No.:
Owner or Tenant: "NNW c,L el.,,1Lie,6Z Email:
Owner's Address: Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes4 No❑Permit No.:
Purpose of Building: Utility Authorization No.:
Existing Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:
New Service: Amps / Volts Overhead❑ Underground 0 No.of Meters:
Description of Proposed Electrical Installation: /4 M Pt&ti7 lAi'R.' .) 04 APB 7, i f:c.k.
)v 673-15 a:nV tr„rt 1Vv Y;Rd,-) C\/A1v5 t 7 ASS c,,mi4,1,s c-r - CE-i vi_. L -5 (i d1 U1n:,,)
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-Grad.0 Above-Grnd.0 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 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 0 Level 1 ❑ Level 2❑ Level 3 ❑ Rating:
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy)
Date Work to Start: C Inspections to be requested in accordance with MEC Rule 10,and upon completion.
,FIRM NAME: t by At Jew 5 A V-A A-1 0 or C-1 0 LIC.No.:
Master/Systems License • LIC.No.:f�'�(� c
tt U 1 ` LIC.No.: �ce/LJ cj�9C Fi i f'tti C i 6Journeyman Licensee:
Security System Business requires a Division of Occupatio Licensure"S"LIC. S-LIC.No.:
Address: P c* 1 11 G5-71iv 010 m yl GL,/ c j
86
Email: abt,,,,.
CDti A 3 9 G NI,L. .Cap, Telephone No.: g b VZ4"0
I certify, d th pain and p nalties of perjury,that the information on this_application is true and complete.
• Licensee:V- Print Name: ut ��a J Cell.No.:
INSURANCE COVERAGE: nless 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 of ame to the permit issuing office.
CHECK ONE: INSURANC BOND❑ OTHER 0 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. I am the:(Check one)Owner❑ Owner's agent❑
Owner/Agent: Tel.No.:
Signature: Email.: