HomeMy WebLinkAboutBLDE-23-19985 12/8/23,6:01 AM about:blank
.)j Commonwealth of Massachusetts ov• Y4'
* Town of Yarmouthc.
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ELECTRICAL PERMIT
Job Address: 52 SPRINGER LN Unit:
Owner Name: HARTSHORN STANFORD H III HARTSHORN SUSAN E
Owner's Address: 109 CHERRY ST Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19985
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Wiring for bedroom, dining room, & living room.
No.of Receptacle Outlets: 20 No.of Switches: 6 Generator KW Rating: Type:
No. Luminaires: 4 No.of Recessed Luminaires: 8 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 Cl No.of Self-Contained Detection/Alerting Devices: 1
No.Oil Burners: No.Gas Burners: Video System ❑ No.of Devices:
No.Air Conditioners: Total Tons: Telecom System ❑ No.of Outlets: 2
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: $ 10,000 Work to Start: December 11, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: JOSEPH L MONIZ License Number: 14635
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: SOMERVILLE, MA, 021453236 SOMERVILLE MA 021453236 Fee Paid: $75.00
Email:joe@monizelectric.com Business Telephone: 617-592-5079
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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about:blank
Commonwealth of Massachusetts �23 Official u : v`
__ Permit No.: —v
_ Department of Fire Services Occupancy and Fee Checked:
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4' BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/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: i - 7- �
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): ,5 a ,5 P/iw€i? L Ai Unit No.:
Owner or Tenant: $-Tianh f f' Sue. /-I4e7SAUPA/ Email:
Owner's Address: ��,z S h2 huEE2 Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No❑Permit No.:
Purpose of Building: 00 c_Le 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: u3 i 21ru9 R&i•266,tt t Qi MluM9/ftYj y e /i viAJ9 /oe,41,
a„7tt 00.f1its ,Li5rri+s e Sir.mrGw�
Completion of the following table may be waived by the Inspector of Wires.
No.of Receptable Outlets: ) No.of Switches: 6, Generator KW Rating: Type:.
No.Luminaires: Lte No.of Recessed Luminaires: R' 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: 1
No.Oil Burners: No.Gas Burners: r 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 0 Level 3❑ t ,r..
OTHER: C--E 1 V D
Attach additional detail if desired,or as required by dam-the Inspector of Wires. iDEC 0 7 2023
Estimated Value of Electrical Work: .%icL000 (When required by tnuLDtEC
alf,ppolic�y) J
Date Work to Start: / // 3 Inspections to be requested in accordance with MEC Rule�O,anid upon corm >rc tT
FIRM NAME: /D/7tZ A-1 0 or C-1 ❑LIC.No.: 2. 7
Master/Systems Licensee: ep ,/ Ji 2 LIC.No.: ,A i'ci3S
Journeyman Licensee: LialiCog /7204/2 LIC.No.: ,?,2..a.co/
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: 23 end e,U ST Siyltile;ad,z.
Email: [/Alla. COM Telephone No.: 6 17- 2-Sd 7?
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
Licensee: Qadth Print Name: cibli.P14-MO/II'Z Cell.No.: 6217-S 2JZl79
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 El 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.: