HomeMy WebLinkAboutBLDE-24-81 1/17/24,6:08 AM about:blank
Commonwealth of Massachusetts of yam .,
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Town of Yarmouth
ELECTRICAL PERMIT
Job Address: 77 TAFT RD Unit:
Owner Name: ROSE JUDITH E TRS JUDITH ROSE TRUST
Owner's Address: 77 TAFT RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-24-81
Existing Service Amps/Volts Overhead ❑ Underground D No. of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: septic pump &alarm
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.❑ 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: $ 1,000 Work to Start: January 16, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: JOHN M PIMENTAL License Number: 27968
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: EAST FALMOUTH, MA, 025365455 EAST FALMOUTH MA
025365455 Fee Paid: $50.00
Email:jmpinstaller@aol.com Business Telephone: 508-566-4472
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 O Y I
! Permit No.: " �— L 1-+ 11 gt Department of Fire Services Occupancy and Fee Checked:
ii
1:1_ BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
,%.-`0 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:
To the Inspector of Wires:By this application,the n rsigned ives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): _7 d 1446(- l4,/^1Ks Unit No.:
Owner or Tenant: v'6tl -Re,s- Email:
Owner's Address: 1�joNt,.C.._ Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes ❑ No(Permit No.:
Purpose of Building: et 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: it)trte. Car 5al-tL R'wve 4 1 "1
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 IIP: Total KW:
No.Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No. of Devices:
Swimming Pool:In-Grnd.❑ Above-Grad. ❑ 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: I
No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of pia' c �+ _ a, c J
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment a` I ' °. D.
No.of Modules: Roof-Mount❑ Ground-Mount 0 Level 1 ❑ Level 2 0 Level 3 0 Rating: 7
OTHER: hAN 1 ZO 4
Attach additional detail if desired, or as required by the Inspector of Wires. BUILDING DEPARTMENT
Estimated Value of Electrical Work: / inD (When required by ea�it<ietpk
Date Work to Start: I --/7-,9`{ Inspections to be requested in accordance with MEC Rule 10, and upon completion.
FIRM NAME:
A-1 0 or C-1 ❑ LIC. No.:
Master/Systems Licensee:
� LIC.No.:
Journeyman Licensee: S ohtn ►44 1'i M-e , LIC.No.: e9 4I p /`
Security System Business(es requires a Division of Occupational Licensure"S"LIC./ S-LIC.No.:
Address: e 30 `�✓C i-L, -5 t f Lr ' k + J jvi& - � Ss. 6 a.6 to
Email: J VV1 P"ri,S Iit4Gt�e r" C")aG[r _ Telephone5 O 5.6 'i72
�Wl No.:
I certify,un II a pains penalties o perjury,that the information on this applicatio is true and complete.
Licensee: int-Name: d Ill-91 /e/ �% ,�. W
INSUR CE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work mayissu��ess the lli see ��
provid 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 sa e 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.:
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