HomeMy WebLinkAboutBLDE-23-15860 - Commonwealth of Massachusetts " ,,of Y.q�
*.4 Town of Yarmouth ' T ' a`
ELECTRICAL PERMITit
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Job Address: 30 BREWSTER RD Unit:
Owner Name: KELLY LAVIN NANCY
Owner's Address: 36 HIGH ST Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-15860
Existing Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
New Service Amps/Volts Overhead 0 Underground 0 No. of Meters:
Description of Proposed Electrical Installation: Install new lights
No.of Receptacle Outlets: No.of Switches: Generator KW Rating: Type:
No. Luminaires: 2 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 0 Level 1 ❑ Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: May 17, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: WELLINGTON R SOARES License Number: 21075
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: HYANNIS, MA, 026011864 HYANNIS MA 026011864
Email: info@wrselectrician.com Business Telephone: 508-778-5936
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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RECEIVED
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MAY 17 2023
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�� BRING DEPART v �+ OffcialUseOnly// ��,
zt -- — rtmenl o� Permit No. �3 v e C.o
}ire Serviced
f f Occupancy and Fee Checked
,.. c` BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071
(leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
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All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: (0 S - %0 ' Z 3
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
k) Location(Street&Number) 3 J S 7 R-O A Q
cli Owner or Tenant A1 L4 NC f q pe f/O
Telephone No. $vg 3 f $y II
g ? Owner's Address
(�, ❑ (Check Appropriate Box)
Is this permit in conjunction with a building permit? Yes 7 No
V Purpose of Building Utility Authorization No.
Existing Service Amps / Vul;s Overheads❑ €r dgi d No.of Meters
New Service Amps / Volts Overhead E Undgrd E No.of Meters
Number of Feeders and Ampacity t.
Location and Nature of Proposed Electrical Work: N s-74 i' Z 9"k e. 10 6X I S 1!111 Cj
a A_(cc F il L, 7 t , C_i 2.t_.t,t t-
vo Completion of the followin,gtable may be waived by the Inspector of Wires.
Lii No.of Recessed Luminaires No.of Ceil.-Sasp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
st No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grad. Battery Units
No.of Receptacle Outlets No.of Oil Burners
FIRE ALARMS INo.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
1=' No.of Ranges No.of Air Cond. Total
Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number j Tons 1KW No.of Self-Contained
Totals: ( Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW
al❑ Municipal
Connection ❑ Other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.ofNo.of Devices or Equivalent
Heaters KW No.of Data Wiring:
Signs Ballasts No.of Devices or E uivalent
No.Hydromassage Bathtubs 'No.of Motors Total iiY Te!eeomm inic tiens Wiring:
I No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (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 issuing office.
CHECK ONE: INSURANCE 0 BOND ❑ OTHER ❑ (Specs
I certify,under the pains andpenalties ofperjury, )
that the information on this application is true and complete.
FIRM NAME: W e Ce�.� R.- S Lt-r� (Age,744 44 A- ) I A C LIC.NO.: 2107.S A
Licensee: e a .SDI'l ignature
(If applicable,enter"exempt"in he license lumber
L ber line)
--c LIC.NO.: 4 �b
Address: /Try 14 4 Bus.Tel.No.:�P °778 .51 3,6
*Per M.G.L.c. 147,s.57-6�security work requires Department of Public Safety"S"License: Alt.Tel.
No.: I7� �4' SW'7 7
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/Agent El owner's agent.
Signature Telephone No. ` PERMIT FEE: $ �-0/ - I