HomeMy WebLinkAboutBLDE-23-15910 5/22/"3,4:38 PM about:blank
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Commonwealth of Massachusetts - v Y. '�
*� Town of Yarmouth ' - o
ELECTRICAL PERMIT -A ��'' ' `
Job Address: 248 CAMP ST UNIT H6 Unit:
Owner Name: GALLIGAN JOHN P TR KOONCE RICHARD H TR
Owner's Address: 248 CAMP ST UNIT H6 Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-15910
Existing Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground ❑ No. of Meters:
Description of Proposed Electrical Installation: install GFI outlets new plugs&switches,AFCI circuit breakers,w new light
fixtures (508-776-1857)
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.0 Hot Tub❑ 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 ❑ 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: May 23, 2023
FIRM NAME: A-1 License Number:
Master/System and/or Journeyman Licensee: NEIL SCHOENER License Number: 13949
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: 44 Traders Lane W YARMOUTH MA 026733333
Email: neileileen@comcast.net Business Telephone: 508-776-1857
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
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=* Permit No.: 5
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� ' Department of Fire Services Occupancy an Fee Checked: C)
`�' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
''" "' 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: ,j —2 2—2.-CJ2 3
To the Inspector of Wires:By this application,the undersigned gives no ices()pis or her intention to perform the electrica work described below.
Location(Street&Number): 2La' Ldl/l�.Unit No.: H - 6
Owner or Tenant: % D i^i ill /Yl OCIt a/// Email:
Owner's Address: Pe No.:
Is this permit in conjunctio ith a building permit?(Check appropriate box)Yes Q1/"No u Permit No.: O73 — OD rja//
Purpose of Building: P / "need
Utility Authorization No.:
Existing Service: 1(Po Amps//,-a/ ) 0 Volts Overhead 0 Underground E 1 No.of Meters: /
New Service: Amps / Volts . Overhead❑ Underground❑ No.of Deters:
Description of Proposed Electrical Installation: /115 heee &Jr. ®vitar3 /I „/ 4 S f4v21A6P
/¢-I c-.LT Ct/'Gt/1 i 6 J? JZ? -cam rti-e-c.J 1/G 4 T 4-x r /r
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: 0 7--
No.Appliances: KW: No. Water Heaters: KW: No.Transformers: Total KVA: LiJ
Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW: > o li
;
No.Heat Pumps: Total KW: Total Tons: Fire Alarm System 0 No.of Devices: .
SwimmingPool:In-Grnd.❑ Above-Grnd. I s.� 1 w 1 0 Hot-Tub 0 No.of Self-Contained Detection/Alerting Devic $.�..:�I��r ,�
No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices: 0 z
No.Air Conditioners: Total Tons: Telecom System 0 No.of Outlets: w ;` :E n'
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: m
No.of Modules: Roof-Mount 0 Ground-Mount 0 Level 1 0 Level 2 0 Level 3 0 Rating: —OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: ;Jt P-00 0 (When required by municipal policy)
Date Work to Start: 5.'- 23 ' 2-023 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: I 5 G Gt O C n e i A-1 0 or C-1 0 LIC.No.: ,4i 3'1j9
1�
Master/Systems Licensee: et(7 5-ektenu/- LIC.No.: A1 3 9 'I,
Journeyman Licensee: LIC.No.:
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: C(q" rci -.5 £;u-
Email: 4Ct i -ct free 0 CO4tcb r elt p ct: 77""/''.S-2
Telephone No.: '-
I certify,under a pins an penalties of perjury,that the information on this application is true and complete.
Licensee: �,e{/� -'c;�1G—" Print Name: ��t/�kk,- .t/' Cell.No.: Or 7 /ZS 7
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"comp ed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage
is in force and has exhibited proof of s 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 signature below,I hereby waive this requirement.I am the: (Check one)Owner❑ Owner's agent❑
Owner/Agent: Tel.No.:
Signature: Email.: