HomeMy WebLinkAboutBLDE-23-19026 6/28/23,3:52 PM about:blank
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Commonwealth of Massachusetts ��� Y '
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Town of Yarmouth
ELECTRICAL PERMIT � F
Job Address: 21 GRANDVIEW DR Unit:
Owner Name: KENNEDY DAVID S GARRITY JEAN M
Owner's Address: 11 BENTON ST Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19026
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: Mini split system
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.❑ 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 0 Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: June 28, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: JAMES M VENUTI License Number: 15798
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: W BARNSTABLE, MA, 026681340 W BARNSTABLE MA
026681340 Fee Paid: $50.00
Email:jvenuti@mac.com Business Telephone: 508-428-7000
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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L� C..onnswntuealth of 77/46.4acLcth Official Use Only
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-1-3 -0\0 2 4,
+ r� Permit No. e(�
�cpaFimerti o 15iee Seevice.4
Occupancy and Pee Checked I
, ' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) (leave blank)
APPUC .11Or FOR PERMIT TO PERFORM ELECTRtCAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(1v4EC).527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date; /12s/2,3
City or Town of: Ycvmov rH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street& Number) 2 f r....1.e vi'e.t r"
Owner or Tenant D�u.A, V-a....,in�1 y Telephone No.
Owner's Address
Es this permit in conjunction with a building permit? Yes n No C� (Check Appropriate Boa)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead n Undgrd n No. of Meters
New Service Amps / Volts Overhead❑ Undgrd E No.of Meters
Number of Feeders and Atnpacity
Location and Nature of Proposed Electrical Work: lAj t rL f— c ue tk GS5 A- G M;,,t i
Corn,letion o the ollowin: table . 'be waived b,the Ins,•ctor o Wires.
No.of Recessed Luminaires INo.ofCeil:Susp.(Paddle)Fans Transofta• sforaneas A
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ in- ❑ 'o.o : mergency" Lighting
gruel. grne. Battery Units W ..
No.of Receptacle Outlets INo.of Oil Burners SPIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection End
initiating Devices
No.of Ranges No.of Air Cond. Total No.of AlertingDevices
Tons
_:
No.of Waste Disposers ea€ �iiafap Tons ' o.of Se.f ortt>?in
Totals: 'Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ I tantcipa
Connection ❑ Otter
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No.of Dryers Heating Appliances K.%i' Security ysterns:
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Ballasts
Si ns No.of Devices or Equivalent
No. Hydromassage Bathtubs No.of Motors Total illy Telecommunications rin :
No.of Devices or Equivalent
OTHER:
.4ttach additional detail if desired.or as required by the Inspector of Wires
Estimated Value of Electrical Work: (When required by municipal poi icy.)
Work to Stan: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
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 cove ge is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ['"BOND ❑ OTHER ❑ (Specify:)
I certtfj',under the pains and penalties of�/�erjuri', that the information on this application is true and con-plete.
FIRM NAME: _.)v..;�.-S IA . tA'..n 'F1 i=1 c+v c- .�...>-, / LIC. NO.: /-i 5 % F
Licensee: .� .if��S /14: {iarl.:i- Signature %� -��l�t.4./ti LIC. NO.:
(I%applicable, enter -exempt-in the license:tin
number line.) ,. Bus.Tel.No.•SO F-YZ.-7c.o 6
Address: _r .... o Li S sue in tAj : pa'i '7 Si IC_ 1/1 0 2L66 Alt.Tel.No.:. '5-o -6`4 -5..36.
`Per M.G.L. c. 147, s. 57-61.security work requires Department of Public Safety"S"License: I.ic.No.
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 a_•ent.
Owner/Agent
Signature Telephone No. PERMIT FEE:
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