HomeMy WebLinkAboutBLDE-23-19317 8/9/23,3:08 PM about:blank
Commonwealth of Massachusetts .o ,,= ,„ e
* Town of Yarmouth , ,
• * ELECTRICAL PERMIT �� t
Job Address: 67 HOLLY LN Unit: 430 0(Co5
Owner Name: CARR THOMAS E JR CARR REALTY TRUST
Owner's Address: 22 CHADWICK RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19317
Existing Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Relocate service, add smoke detectors, & remodel bathrooms.
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 ❑ 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: $ 14,000 Work to Start: August 8, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: RAY W BOMBARDIER License Number: 33621
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Mashpee, Massachusetts, 02649 Mashpee Massachusetts 02649 Fee Paid: $125.00
Email: rwbombardier3@gmail.com Business Telephone: 508-274-9282
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:
1 24,
C
-Z-01_1/ , tG WZ3 M-
Ft.spi_e____ 4S2'3 _
about:blank
1/1
�__ Commonwealth ofMassachusetts Official Use On /-�
Permit No.:e 2 id ( /
' -* 1 --;/ Department of Fire Services Occupancy and Fee Chec e : C
• _' [Rev. 1/2023]
t. -:T - BOARD OF FIRE PREVENTION REGULATIONS
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:
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): Ig 11 l'10 t,\f L-N..) Unit No.:
Owner or Tenant: TIA O wA A-5 �L.' C 2-P-AZ a9<t y Email:
Owner's Address: (Q--1, to 0 1 t. 1--1•J Phone No.: ' 7 )it ?.1 a-- i-60
Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No❑Permit No.:
Purpose of Building: l/✓5 %1)—€ tip t — Utility Authorization No.:
Existing Service: 1 00 Amps k>0/ a 4 xolts Overhead-Er Underground❑ No.of Meters:
New Service: I o Amps 1}V / i--Kv Volts Overhead.--{Jnderground❑ No.of Meters: I
w Description of Proposed Electrical Installation: (Ze t.ocv4T LJ 2 e-Pv E'- 5 Q t C`e- c.R.,.,sup t'-'
;NI rewn r ,A-00 4)rhe71c 1CDt 5 1 12ew..o 0(4., $/4-t t+n-aornS
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❑ 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 ❑ 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 ❑ Level 2❑ Level 3 0 Rating:
OTHER:
Attach additional detail if desired,or as requirredpby�t the Inspector of Wires.
Estimated Value of Electrical Work: (-I (When required by municipal policy)
Date Work to Start: Inspections tobe requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME:ii....pf cON �✓`�0 2l-e - A-1 0 or C-1 0 LIC.No.:
Master/Systems Licensee:
LIC.No.: L 3 �p."1-1
Journeyman Licensee:
fZA\ \79 ( _ LIC.No.: E 33 tom1
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: ( (9 fl 19 Li 3 tevei A5 Cto e r W\,- oc)—escN
�' �?4/9�9- '
Email: � W b 0 Y�IDEA 0 A t 21L 3 e'�t^^�i 1 -C�Pt". Telephone No.:
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
Licensee:
Print Name: Cell.No.:
INSURANCE COVERAGE:Unless 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 same to the permit issuing office. Specify: t; t I l �)
CHECK ONE: INSURANCEOND❑ OTHER❑ S P fy:
OWNER'S INSURANCE A A - • ,1) aware that the Licensee does not have the liability insurance coverage normally
required by 1.w pliSyEh}Giggat t ie w Tel.No.:g -reby waive this requirement.I am the:(Check one)Owner 0 Owner's agent 0
-
Owner/Age t: ``
• Email.:
Signature: - , •. - ` 1
A}, EP RTME
BYE