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HomeMy WebLinkAboutBLDE-23-19725 10/23/23,3:05 PM about:blank
Commonwealth of Massachusetts
* • 4
Town of Yarmouth '
ELECTRICALel
PERMIT ,,
Job Address: 24 OAK GLEN VILLAGE Unit:
Owner Name: LOVERIDGE RUTH L
Owner's Address: 24 OAK GLEN VILLAGE Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19725
Existing Service Amps/Volts Overhead ❑ Underground D No. of Meters:
New Service Amps/Volts Overhead D Underground 0 No. of Meters:
Description of Proposed Electrical Installation: Kitchen remodel
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: ln-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❑ Rating:
Estimated Value of Electrical Work: $4,000 Work to Start: October 23, 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:
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Commonwealth of Massachusetts O frcial use{o ly7 -
Permit No.:
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i--: ' � Departmento
G _',0!_ f Fire Services Occupancy and Fee Checked:
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_►_�_ BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023J
"''—" 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: / 0 — �3-- 2 C',---'3
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): C /? ✓ (3-1 G t., 4,C 'yr', ,44c✓z1' Unit No.:
Owner or Tenant: J O ii �% h.4LT l-c t�
Email:
Owner's Address:
Phone No.:
Is this permit in conjunctio with a building permit?(Check appropriate box)Yes❑ No❑Permit No.:
Purpose of Building: K t'r C " e'"\ to.iii G iC c-e
Existing Service: �'�> °9 Amps Izc Utility Authorization No.:
p /'Z'0 Volts Overhead❑ Underground No. of Meters:
New Service: Amps / Volts Overhead❑ Underground g ❑ No. of Meters:
Description of Proposed Electrical Installation: l' 'i TC t+r.-• /Z .m 4 ee-e--- ;
Completion of the following table may be waived by the Inspector of Wires.
No.of Receptable Outlets: No.of Switches:
No.Luminaires: No.of Recessed Luminaires: No. Wind Generator KW Rating: Type:.
No.Appliances: KW: No. Water Heaters: KW: No.Transformers:tors: Wind KW Rating:
Space HeatingTotal KVA:
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:
No.Energy Rating:Storage Systems: KWH StorageTelecom System 0 No.of Outlets:
Security System 0 No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply E ui ment:
No.of Modules: Roof-Mount 0 Ground-Mountpp e q p
OTHER: 0 Level 1 0 Level 2 ElLevel 3 0 Rating:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: i C d 0
Date Work to Start: l D -2 3 -2��t 3 (When required by municipal policy)
Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: N z `1 Csc In d e l -r
Master/Systems Licensee: A-1 ❑or C-1 ❑LIC.No.:
y N -cam S 1 i.-- _.
LIC.No.: ifr 3,'-F ci
Journeyman Licensee:
LIC.No.: L 7 ir t
Security System Business requires a Division of Occupational Licensure"S"LIC.
S-LIC.No.:
Address: N `f'/7_A u�ft-s- (A ( i-t-s r y AIC vt70.-(-)f
Email: i�-C , t 2 ,c� � Cam:•� t.:� _ "iLL-,—t. � _
Telephone No.: ,V ec' 76 —/ S 7
I certify e the pins a penalties of perjury,that the information on this application is true and complete.
Licensee: C 1.CV 2.,- Print Name: Al�&c ( 5 ,< ( 'z--- Cell. No.: 5 el - .77 —1 S 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 0 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 0
Owner/Agent:
Tel.No.:
Signature:
Email.: