HomeMy WebLinkAboutBLDE-23-20039 1; 3 AM about:blank
Commonwealth of Massachusetts o Y- ,°�
* r Town of Yarmouth � , .. -.
ELECTRICAL PERMIT5° ' '�
Job Address: 62 WEBSTER RD Unit:
Owner Name: POULOS PETER TRS POULOS LUCY TRS
Owner's Address: 47 SNOWY OWL LN Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-20039
Existing Service Amps/Volts Overhead 0 Underground 0 No. of Meters:
New Service Amps/Volts Overhead 0 Underground 0 No. of Meters:
Description of Proposed Electrical Installation: Install 50 amp receptacle.
No.of Receptacle Outlets: 1 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: 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: 1
No.of Modules: Roof-Mount❑ Ground-Mount❑ Level 1 ❑ Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $600 Work to Start: December 13, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: JOHN B RAIMO License Number: 18352
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Dennis, MA, 026735009 Dennis MA 026735009 Fee Paid: $50.00
Email: raimoelectric@yahoo.com Business Telephone: 508-725-7259
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the
licensee provides proof of liability insurance including "completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
INSURANCE:
‘? 51,U &-• 14(St-ZZ4E—#_--
about:blank 1/1
Commonwealth of Massachusetts Official Use CAly
I Permit No.: 4,06,--,
t Department of Fire Services Occupancy and Fee Checked:
ctirl.717, BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/2023]
.. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 52- C R 12.00
City or Town of: YARMOUTH_ • Date: 0 ` '�
To the Inspector of Wires: By t! s application,the undersigned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): CD r- Unit No.:
Owner or Tenant:
?.->sad Email: uC.
Owner's Address: Phone No.: 7 -6 p )3c 3
Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No ❑ Permit No.:
Purpose of Building: ( L/ •-' Utility Authorization No.:
Existing Service: Amps / Volts Overhead❑ Underground❑ No. of Meters:
New Service: Amps / Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: rks{c t t l Sc)l 6LL$tL 0 `c&ct... - -t
- e(p t—C c-4 Jf - Cx,'`i- CGX-). \2-Q C r 5 6
Completion of the following table may be waived by the Inspector of Wires. ((( 4
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 IIP: 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 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 Equip,..at:
No.of Modules: Roof-Mount❑ Ground-Mount 0 Level I 0 Level 2 0 Level 3 ❑ RaEgCEIVFD
OTHER: --- —.-._..._....,. __... __...
Attach additional detail if desired, or as required by the Inspector of Wires. DC 3023
Estimated Value of Electrical Work: Oz2— (Whenrequiredp p RTMENT
b�I tip�pei �k o
Date Work to Start: is (k%(X 3 Inspections to be requested in accordance with MEC Rule..l(1,-and iipnn. :mm,l—±ice+•
FIRM NAME: .a L;,.o A-1 ❑ or C-1 0 LIC.No.:
Master/Systems Licensee: i 0C`� I.. (Z tc----
LIC.No.:A-G 6J�.�
Journeyman Licensee: Jtr`� i3 t Z� LIC.No.: /S?/T S
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: c 76, 7 J U Cj. --G*- S
Email: 0-.t_tA%t`f(7(0 & re C ._ ycarocs co;"-L _ Telephone No.: _TOY 7,9 ?a..S' V
I certify,under the pains and penalties of perjury,that the o • on this ppl. ation is true and complete.
Licensee: q ... IJ V e-c,-` Print Name: \ vL, / ((, 5 7
-'"``� Cell.No.: 0 )S- ld�
INSURANCE COVERAGE: 4-'
Unless waived by the owner,no mit 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.
CHECK ONE: INSURANCE ❑ BOND❑ OTHER❑ Specify:
OWNER'S INSURANCE WAIVER: I am are that the Licensee does not have the liability insurance coverage normally
required by law. By my natur 1 , ereby waive this requirement. I am the: (Check one„),Owner❑ Owner's agent❑
Owner/Agent: Tel.No.: �c'!j 7 WI. :. fv:/,),..cc
Signature: ...1/
/ `*Email.: t � /9 Lt,7- ��p