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HomeMy WebLinkAboutBLDE-23-19898 11/28/23,0.30 AM about:blank Commonwealth of Massachusetts ,. o Y ti Town of Yarmouth � ; , , �, � ELECTRICAL PERMIT , - . Pa- Job Address: 10 SEASIDE VILLAGE RD Unit: Owner Name: KALUZA JAMES KALUZA CAROL ANN Owner's Address: 10 SEASIDE VILLAGE RD Phone: Email: Purpose of Building Residential Utility Authorization No.'s�,15413789 Is this permit in conjunction with a building permit? No Permit Number: BLDE-233-19898 Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters: New Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters: Ea" Description of Proposed Electrical Installation: Overhead service upgrade. ijU 1/4104,046, 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: $4,000 Work to Start: November 27, 2023 FIRM NAME: License Number: Master/System and/or Journeyman Licensee: DAVID R NICOLL License Number: 37557 Security System Business requires a Division of Occupational Licensure "S" LIC. License Number: Address: S YARMOUTH, MA, 026641038 S YARMOUTH MA 026641038 Fee Paid: $50.00 Email: dnicoll@comcast.net Business Telephone: 508-360-7313 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: �� 0 t1 I 7,1?'(2-3 K-Zo about:blank 1/1 Commonwealth /�j/ Official Use Only C ommnnwea[t!t o� /®/c ssachu�el�t �rn 0�) !j t*- y Permit No. �j • a[ = -[leparEmenE o� ire �ervice3 '�'— BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ' `0- (Rev. 1/07) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C M C 527 R 12.00 (PLEASE PRINT IN INK OR TYPF4A .I INFORMATION) Date: Ll � l City or Town of: • 7 ,Z (,1 To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to erform the electri� 1 work described below. Location(Street&Number) / Owner or Tenant �i L Telephone No.7 7� 9�-a C Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box)Purpose of Building Utility Authorization No. /5 1L 37-�Q 7 Existing Service 7 J Amps 1,40/ .?4CVolts Overhead ref Undgrd ❑ No.of Meters New Service a Oci Amps DO /dlee Volts Overhead Li Undgrd❑ No.of Meters / Number of Feeders and Ampacity 'i' f Location and Nature of Proposed Electrical Work: �de 0142, � e Cam ' "'6 Cr Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No. of Ceil.-Susp. (Paddle)Fans T f 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 FIRE ALARMS No. of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total 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 Local ❑ Municipal [] Other Connection -+ No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No. of Data Wiring Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: /; 64- ` (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 i suing office. CHECK ONE: INSURANCE 2 BOND ❑ OTHER ❑ (S ecify:) cl h.1 S"CP(( Cbev't ec -S--7'/ --►fi of I certify, under the pkns and penalties of perjury, that the information his application is true complete. FIRM NAME: ..J vi IV LC© Li.... LIC.NO.: .3-Z S-S i E Licensee: " Signature LIC.NO.: (If applicable, enter"exempt"in the license lumber line.) Bus.Tel.No.: 5�08` 39`I-6231 Address: 141i b i Fri,/ 01 N - _, Mk Mk- Li, Alt.Tel.No.: 6'03'3 e`"131,3(Ca. .l) *Per M.G.L. c. 147,s 57-61,security work requires Department of Public Safety "S"License: Lic.No. 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 Signature Telephone No. t PERMIT FEE: ,ii