HomeMy WebLinkAboutBLDE-23-19976 #5 12/6/23,2:25 PM about:blank
Commonwealth of Massachusetts • Y.4 .,.n
* Town of Yarmouth
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-23-19976
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#5)
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: $ 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: $50.00
Email: shawnobrien411@yahoo.com Business Telephone: 508-840-8883
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the
licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
INSURANCE:
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Commonwealth of Massachusetts Official Use Onl
"" Permit No.: _'�--1 c �Vj
=- '_gt Department of Fire Services Occupancy and Fee Checked:
_14 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
'''"-'14 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527 CMR 12 00
City or Town of: YARMOUTH_ Date: /2 / /c 2 3
To the Inspector of Wires:By th. .•p'cation, he undersigned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): .'-- 14,4 r pCY �' R_r j Unit No.: ,$
Owner or Tenant: ? .(,t-,l 0/ mvA31-e Email: S- aevitJ Q j3T-1-
10
Owner's Address: 5'-.'T Al4 R (>c9O Al is `t`t r Q c�'S«,
Phone No.: it'. v -g-3e9-3
Is this permit in conjunction with a buildin permit?(Check appropriate box)Yes❑ No 0 Permit No.: /5 /.„7 (
Purpose of Building: Rd s r .-lE,,� S Utility Authorization No.: c
-��3 6 Ca l
Existing Service: 2
�c� Amps ,# )/ '2OVolts Overhead Underground 0 No. of Meters:,
New Service: a26,U Amps tfc) /fix)Volts Overhead Underground g ❑ No. of Meters:
Description of Proposed Electrical Installation: Iffiti r-t2 6-eN c.-y F7 , ,OS GI j C _ec
/' .P�cr r Pr 1 .4 if)i ))h / o r✓S E M,-rEK
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: Yp
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 0 No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System
No.Air Conditioners: Total Tons: Y 0 No.of Devices:
Telecom System❑ No.of Outlets:
No.Energy Storage Systems: KWH Storage Rating: SecuritySystem
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 n. D
❑ Level 1 ❑ Leve12
OTHER:
El Level ElUpg:
Attach additional detail if desired, or as required by the Inspector of Wires. DEC 06 2023
Estimated Value of Electrical Wog: cqe3b d
(When required by mu ici�l.policy)Date Work to Start: Inspections to be requested in accordance with MEC Rule I Bn�� pon ompletTMF_NT
�,aY. ups n co►nplerinn
FIRM NAME:��li r/ 0 12-/C-A)
A-1 0 or C-1 0 LIC.No.:
Master/Systems Licensee:
LIC.No.:
Journeyman Licensee: -7i,•it r ez_,,t) cy C12 I c� 4 3 t
LIC.No.: 7
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: /2 43 L f' /&J $ i Ca,-7et'-- --- N
Email: F // t a
�! - 1-��/� .�/� Telephone No. eg
I certify,under pai nd penalties of perjury,that the information on this application is true and complete.
Licensee: Print Name: 5 P% CVL O a
INSURANC COVERAGE: Unless waived by the owner,no permit for the performance electrical work issue
provides proof of liability including"completed operation" may unless he licensee
p 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 normal)
required by law. By my ' natur below,I ereby wa'v this requirement. I am the: (Check one)Owner❑ Owner's agent 0
Owner/Agent: ,r-=1
Signature: .er
Tel.No.:S'� 7 7
Email.: ��