HomeMy WebLinkAboutBLDE-24-421 3/17/24, 12:12 PM about:blank
AL '(1/1 Commonwealth of MassachusettsoF • .� ..
* Town of Yarmouth 0�:
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ELECTRICAL PERMIT
Job Address: 22 CHASE GARDEN LN Unit:
Owner Name: BUTLER THOMAS R
Owner's Address: 22 CHASE GARDEN LN Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-24-421
Existing Service Amps I Volts Overhead 0 Underground ❑ No. of Meters:
New Service Amps/Volts Overhead 0 Underground El No. of Meters:
Description of Proposed Electrical Installation: 50 Amp circuit for car charger. (EV)
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: 1
No.of Modules: Roof-Mount❑ Ground-Mount❑ Level 1 ❑ Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 2,000 Work to Start: March 12, 2024
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: $50.00
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 ZalUse O
__ Permit No.:
I =.4= t Department of Fire Services Occupancy and Fee Checked:
MI BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
-77.` 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: YAR M O UTH_ • Date: 3 — i 3 -- 2 d g24
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): a.2, Ci/AS e Cx/CeD,e4 LA) Unit No.:
Owner or Tenant: I 0 M 1 ,VTI e.g .— Email:
Owner's Address: Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No�ermit No.:
Purpose of Building: C A re- C E4 6e-A Utility Authorization No.:
Existing Service: ZUO Amps /2.&/ 2`l0 Volts Overhead❑ Underground[ - No.of Meters:_j
New Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:
Description of Proposed Electrical Installation: /¢ce d fiQ 1 eve C" 7 T D
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 0 No.of Devices:
Swimming Pool:In-Grnd.❑ Above-Gmd.❑ Hot-Tub❑ 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❑ Ground-Mount 0 Level 1 ❑ Level 2❑ Level 3❑ Rating:
OTHER:
. ......... ......
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: c,D®D ' (When required by municipal policy)
Date Work to Start 3—i2•iikif Inspections to be requested in accordance with MEC Rule 10, and upon completion.
FIRM NAME: l v e c ( S G l ta.e. 1 e -- A-1 ❑or C-1 ❑ LIC.No.: it 3f 5'
Master/Systems Licensee: LIC.No.:
Journeyman Licensee: LIC.No.:
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: Lf 4 .1--r411 itS CAI.
Email: 6 C i c‘t , C Cvr.✓t-t ...tt..t-r' Telephone No.: `J"Q$ 77k,— (S`S7
I certi under re pains ands� enaal 'es of perjury,that the in o nation on this application is true and complete.
Licensee: t2 .�eJ. Ei i�G� Print Name: jZif( Si- 0-e't--- —
/ � Cell.No.: ��6' �6 113)
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❑ 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.: