HomeMy WebLinkAboutBLDE-23-19977 #7 12/6/23,2:29 PM about:blank
Commonwealth of Massachusetts o. •,`yam
Town of Yarmouth Al
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ELECTRICAL PERMIT .,
Job Address: 5 &7 HARPOON LN Unit:
Owner Name: DIMONTE RALPH DIMONTE NANCY EVE
Owner's Address: 17 RABBIT LN Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19977
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Service repairs (HOUSE#7)
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: ln-Grnd.0 Above-Grnd.0 Hot Tub 0 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: $ 2,000 Work to Start: December 6, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: SHAWN E OBRIEN License Number: 31974
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Cotuit, ma, 02635 Cotuit ma 02635 Fee Paid: $50.00
Email: shawnobrien411@yahoo.com Business Telephone: 508-840-8883
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the
licensee provides proof of liability insurance including "completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
INSURANCE:
6.1,I, & ( a(-z-- ((E._ 6y cmit-76 f' "Ea :LID 0)
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Official Use Oltl r.,q 7 7
Commonwealth of Massachusetts Permit No.: � .—. ((t1�
I t Department of Fire Services Occupancy and Fee Checked:
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
%".—.4` APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527 CMR 12.00
City or Town of: YAR M O UTH_ • Date: !;Z i k l b2 3
To the Inspector of Wires: By this p licati e undersigned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): -- _ A r P7/J /2r-1 Unit No.: 5—
Owner or Tenant: `? 4( /(/ p1 OA.)1--e Email: ._S/?gw/J o13rt-10 ' t ( ey "_c„,
Owner's Address: 5' -7 Aim_R (=>dd /J /Z-d Phone No.: 56g-- Re/0 -g -9 -3
Is this permit in conjunction with a building permit?(Check appropriate box)Yes E No❑ Permit No.: /5 3 lC /.2
Purpose of Building: Rd S f '21e.t.74$ Utility Authorization No.: /5- :3 G (" 1
Existing Service: 7d _, Amps t7i'/ ?ZOVolts Overhead Underground❑ No. of Meters:,
New Service: c2a U Amps ((c) /,221-)Volts Overhead Underground❑ No. of Meters: 3
Description of Proposed Electrical Installation: !EGO f G-'/N 6--(-/ ,7 E7 - l- b%S GCl c---i
77.e ger r i / Xt/t)i', A-b I) / A 1 O c-S E _/44 IA 7> ,
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.0 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 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 0 Level 2❑ Level 3 ❑ ti�rg: e ^ E ' c D
OTHER: P'\ DECl• 2023
Attach additional detail if desired, or as required by the Inspector of Wires. D 0 6
Estimated Value of Electrical WA: 0.76.0 d (When required by mu icillalpolicy))-PARTMENT
Date Work to Start: Inspections to be requested in accordance with MEC Rule 1 ,a4In upoNn comp�letintL
FIRM NAME: -f-Cjt/ 0/v/2/C/0 A-1 ❑ or C-1 ❑ LIC.No.:
Master/Systems Licensee: LIC.No.:
Journeyman Licensee: c5-Afe r arc) 0 0-(c/I-) LIC.No.: tom-- 3 t(7
Security System Business requires a Division of Occupational Licensure"S"LIC. y�,� S-LIC.No.:
Address: /2 4 3 ill t .//L1 5 7" ?LU/�7 ,4 f (� �^�
Email: (�5 /F 4J II �' f-a��l9 �-i IUI Telephone No. �S` ge " ��3 �S 3
• I certify,under pai nd penalties of perjury,that the information on this application is true and complete.
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Licensee: Print Name: �14Awou O' ► �� Cell.No.: 4i-o '
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.
CHECK ONE: INSURANCE ❑ BOND❑ OTHER❑ Specify:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my r below,I,biereby w i e this requirement. I am the: (Check one)Owner❑ Owner's agent❑
Owner/Agent: e i Tel.No. Sr- .. 5? 5-7 r L
Signature: Gam. Email.: 4/4