HomeMy WebLinkAboutBLDE-23-19773 11L3,-fi: 0 AM about:blank
'''Z Commonwealth of Massachusetts of• Y� .,
* Town of Yarmouth
304' , C
t ELECTRICAL PERMIT �� $
Job Address: 31 GRIST MILL LN Unit:
Owner Name: PYTHON JOHN PATRICK LOUGHMAN JULIA F
Owner's Address: 8 THISTLE LN Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19773
Existing Service Amps/Volts Overhead 0 Underground El No. of Meters:
New Service Amps/Volts Overhead 0 Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Security&fire system installation
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 Si No.of Devices: 9
Swimming Pool: In-Grnd.❑ Above-Grnd.❑ Hot Tub❑ No.of Self-Contained Detection/Alerting Devices: 12
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 SI No.of Devices: 12
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 0 Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 5,700 Work to Start: October 30, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: ROBERT K BOUCHER License Number: 1317
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number: 0046
Address: S YARMOUTH, MA, 026644455 S YARMOUTH MA 026644455 Fee Paid: $45.00
Email: dax a(�seasidealarms.com Business Telephone: 508-394-0599
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 Official Use Only
Permit No. Z 1 7 7 3
at , Department of Fire Services .
at Occupancy and Fee Checked
. e r BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05]Y
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APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /0- 3 C'_ 3
City or Town of: /a-v-morn: To the Inspector of Wires:
By this application the undersigned gives notice of his or,[( 4'l her intte�nttion to performr the electrical work described below.
Location(Street&Number) / G Y'('-r l- i C if f
Owner or Tenant 4ic.PLC'H Ssro244e0-„,rj-f., ,—Q y' H QcuSw eh Telephone No.�cif. S
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Owner's Address .- t 3 tf ''��/- Ciy ,p.i At Da.z�f
Is this permit in conjunction with a building permit? es No (Check Appropriate Box)
Purpose of Building 12��dken[Z Q I Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: W vc//c-. se,,,..47. A
�.2t-z, c,h7..,i++ C 4Ck 4.
Completion of the following table may be waived by the Inspector of Wires.
otal
No.of Recessed Luminaires No.of Ceil:Sus .(Paddle)Fans No. TVA
P Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.a ofe N,Unitsmergency Lighting
gruel. gruel. ry B tt
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones /
No.of Switches No.of Gas Burners No.of Detection andev I
Initiating Dices
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump Number_Tons__.KW No.of Self-Contained Cy
Po Totals: Detection/Alerting Devices /
No.of Dishwashers Space/Area HeatingKW Local❑Municipal ®,title.
P Connection
No.of DryersHeating Appliances KW Security Systems:*
No.of Devices or Equivalent/.--
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.H dromassa a Bathtubs No.of Motors Total HP TelecommunicationsNofDisor quia l
Y g nn r ,( No.of Devices Equivalent
OTHER: �0-Cx Sen�arl--C�) ` A7Q.4-`c>JT rh,uS1�J3
Attach additional detail ifdesired or as required by Mt Inspector of Wires.
Estimated Value of Electrical Work:Sty-oO" (When required by municipal policy.)
Work to Start:/9-.)I)-, -3 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 coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE a BOND 0 OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application Is true and complete
FIRM NAME: Seaside Alarms inc. ((�� f� LIC.NO.: 13(7f
Licensee: Robert K.Boucher Signature . IA Pa c.s owfLlC.NO.:
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: .;0R-t94-0599
Address: (265 Route 28.South Yarmouth.MA 02664 Alt.Tel.No.:
*Security System Contractor License required for this work;if applicable,enter the license number here: s-0046
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)0 owner ❑owner's agent.
Owner/AgentSignatureTelephone No. I PERMIT FEE:$ �S' ''
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