HomeMy WebLinkAboutBLDE-23-19660 10/12/23,5:25 AM about:blank
Commonwealth of Massachusetts -og. y.44,3.,;
*„ ,-\/ Town of Yarmouth
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ELECTRICAL PERMIT
Job Address: 118 CROWELL RD Unit:
Owner Name: BUTLER MITCHELL W SPELLMAN BUTLER DENISE
Owner's Address: 77 CARLISLE RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19660
Existing Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Remodel basement
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.❑ Above-Grnd.❑ 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❑ Level 1 0 Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $4,000 Work to Start: October 11, 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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RECEIVED CV/4\k�
1:-. 1 2023�!o moo�nwealth of Massachusetts Permit No. z-gial O l 9 l f
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d 'PARTME T a epartment of Fire Services Occupancy and Fee Checked:
Br`� /!'-:•' a SF FIRE PREVENTION REGULATIONS [Rev.I/2023j
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 MR 12.00
City or Town of: YARMOUTH Date: ®Q —1) — 2023
To the Inspector of Wires:By this a lication,the undersigned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): it e c-r o tde.i t /1d• W tS%yletrar�faNtit No.:
Owner or Tenant: m 1 lea C6l b V rl e. EmaiY.
Owner's Address: hone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes a No❑Permit No.:itt o?3 -1,R 903
Purpose of Building: e Xl 511 rl j t 4TGww4-/`CMa ca2 Utili uthorization No.:
Existing Service: /2e/2`ft7 Amps gam- Volts Overhead LW-Underground❑ No.of Meters:
New Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:
Description of Proposed Electrical Installation: R-P fill t C . 6 4-se m" 12e f
Completion of the follinving 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-Gmd.❑ Above-Grad.0 Hot-Tub 0 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 0 Ground-Mount 0 Level I❑ Level 2❑ Level 3❑ Rating:
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 'g 1-1 D w (When required by municipal policy)
Date Work to Start:,, )s -I 1-gta 1-.3 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
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FIRM NAME: V e i Lc�SGL o eke.C1 A-1 0 or C-1❑LIC.No.:
Master/Systems Licensee: / --w LIC.No.: i 31 tI
Journeyman Licensee: LIC.No.:
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: 4
Email: /) G 1 L tic 1•eG - Ol _ Ca.net si r G>` Telephone No.: J b ' -7X
I certify unde the pains d penalties of perjury,that the Inform/ion on this application is true and complete.
Licensee: Print Name: NU.1 g Cell.No.: /7"77Lt8f-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❑ 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.:
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