HomeMy WebLinkAboutBLDE-23-19047 '23, 1:59 PM about:blank
Commonwealth of Massachusetts jog Y..
*
3tV
Town of Yarmouth
c:
ELECTRICAL PERMIT
Job Address: 231 IOV I t LL t/ cr Unit:
Owner Name: /, / r; We v, - K
Owner's Address: Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19047
Existing Service Amps/Volts Overhead ❑ Underground 0 No. of Meters:
New Service Amps/Volts Overhead 0 Underground 0 No. of Meters:
Description of Proposed Electrical Installation: 30 Amp sub panel &circuit for green house. (With Underground)
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 0 No.of Devices:
Swimming Pool: In-Grnd.0 Above-Grnd.❑ 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 ❑ 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 0 Ground-Mount 0 Level 1 0 Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 3,000 Work to Start: July 3, 2023
FIRM NAME: 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: W YARMOUTH, MA, 026733333 W YARMOUTH MA 026733333 Fee Paid: $75.00
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:
/--- --' -2/,47 3
1.• CA (G t-23 (c
about:blank
1/1
\ .:„-,
N
Commonwealth of Massachusetts Orficial Use OnLv
�p=" - ,l Permit No.: Z3 — ( Q Lt 7
_ '��= Department of Fire Services Occupancy and Fee Checked:
��— BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
''"'—"1` 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: —7 — 3 20 a3
To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): -7 3 3 ist/i 11 e t.,d 5 t S S. 14,z.Alt 4lnit No.:
Owner or Tenant: LA W t-..€1 C e /110 ip,/.4/ mail:
Owner's Address: 0 -c e-) Cv,r ten, N- a6e hone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes No❑Permit No.: B5 /io - a3 -a 3
Purpose of Building: Utility Authorization No.:
Existing Service: Amps / Volts Overhead❑ Underground❑ No. of Meters:
New Service: Amps / Volts Overhead❑� Underground❑ No.of Meters:
W
Description of Proposed Electrical Installation: i re,. 3/2 4 i'z` 5 )tS e I No 1-1-4: Circe IT
6 PIA ittc 14 et d /',cer) t:3� , 61ehaa✓.�r' i6 4� G-i P I t Geis G hr
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.❑ 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 0 Level 3 0 Rating:
OTHER: — _
Attach additional detail if desired,or as required_bi'the Inspector of Wires.
Estimated Value of Electrical Work: . -5 0&U (When required by municipal policy)
Date Work to Start: '1 —/ 21.3 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: NO l Z S r�IOGrc e r— ❑ �l 9 i/
/ A-1 0 or C-1 LIC.No.:
Master/Systems Licensee: � ...e t,e, LIC.No.: 4 t 9 t"
Journeyman Licensee: LIC.No.:
Security System�Bussiness requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
l
Address: ` g 7'i € I L 4 ie, sif
Email: rl Pam► t (er
{,, C- Cep+rt.C-gt b r' . el e fr Telephone No.: c®f-. >6-47.S7
I certify unde thepains aid penalties of perjury,that the information on this application is true and complete.
Licensee: ...,."--WeP4--' Print Name: dV/e t f'
,S-G-A0C-,ems Cell.No.: SD 7.7-26-"I YS 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"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 0 OTHER 0 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.: