HomeMy WebLinkAboutBLDE-23-19978 12/6/23,2:39 PM / about:blank
:, e ` Commonwealth of Massachusetts -ov: Y .
*u4Town of Yarmouth
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ELECTRICAL PERMIT �� �
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Job Address: 48 WILD HUNTER RD Unit:
Owner Name: MICHALSKY JOSEPH (EST OF)
Owner's Address: 48 WILD HUNTER RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19978
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
Description of Proposed Electrical Installation: House renovations
No.of Receptacle Outlets: 30 No.of Switches: 20 Generator KW Rating: Type:
No. Luminaires: No.of Recessed Luminaires: 30 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: 4
No. Oil Burners: No. Gas Burners: Video System ❑ No. of Devices:
No.Air Conditioners: 1 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❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 10,000 Work to Start: December 4, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: EDWARD M LYNCH License Number: 35609
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: WEST YARMOUTH, MA, 026733818 WEST YARMOUTH MA
026733818 Fee Paid: $75.00
Email: pinchcalllynch@icloud.com Business Telephone: 7 4-208-8338
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performan a ec rlcal 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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1 Commonwealth of Massachusetts ofRcial U_Vi y ,G�
_ r/ PermitNo.:C�? 5 R`C?U
t_111_ Department of Fire Services Occupancy and Fee Checked:
-•_°►I BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/2023]
"•—�'` APPLICATION FOR PERMIT TO PERFORM ELECTRICAL ORK
All work to be performed in accordance.with the Massachusetts Electrical Code(MEC) 527 M 2
City or Town of:_YARMOUTH Date:
To the Inspector of Wires:By i ap cayoq Me m is' d give i .ces of his or her intention to perform the elect!' w described below.
Location(Street&Nu�j er): /(/ Unit No.:
Owner or Tenant: /?Q (r B /j Email:
Owner's Address: Q e. Phone No.:
Is this permit in conjunc n wi ¢uilding permit?(Check appropriate box)Yes❑ No 0 Permit No.:
Purpose of Building: tility Authorization No.:
Existing Service: Amps /X/ olts Overhead Underground❑ No.of Meters:
New Service: Amps / tie
,Volts Overhq Undergro d❑ No.of'Meters:
. Description of Proposed Electrical Installation: t ieti,5'e AY(>/J/,�� ?I1
Completion of the following table may be waived by the Inspector of Wires. r
No.of Receptable Outlets: No.of Switches: Generator KW Rating: Type:
No.Luminaires:�0 No.of Recessed Luminaires: f 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 D No.of Devices:
Swimming Pool:In-Grnd.0 Above-Grad.0 Hot-Tub-0 No.of Self-Contained Detection/Alerting De t
No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices:
No.Air Conditioners: / Total Tons: Telecom System❑ 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 Sup ui ment:
No.of Modules: Roof-Mount 0 Ground-Mount❑ Level 1❑ Level 2❑ Lt veR Ir etl rEy:I V E D
OTHER: -----------
Attach additional detail if desired,or as d rye Inspector of Wires.
Estimated Value of Electti I rk. �QQ (When regsir0 ict policy.
B D Da__Ipl(e�
Date Work to Start: Ins ecuons to be requested in accordance with MEC Rule 0,and upon co�nl9etion.
FIRM NAME: A-1 0 or C-1 0 LIC.No.:
Master/Systems Licensee: LIC.No.:Journeyman Licensee: .(4'/)i(17/J �. LIC.No.: .7 4-/7t /
Security System Busines4oi
requires a Division of ccupational Licensure"S"LIC. l S-LIC.No.:/
Address: ).-5—G 6 ,//e. 7rj,gref??�?f
Email: P 4 ci%(�Q//f y./f G'!f/')l(lad, YA Telephone No.: 7l T —/v O
I certi,lite p,air arr�g4 a /ties perjtury,that the inn ofmaiiononds appllcadon Is ue and complete. 7 ,LicenseeU�r/7 Print Name: j�(f te/' 4 jj (/c Cell.No.: 77 ---'2'/,9���
INSURANCE COVERAGE:U ess waived by the owner,no pe it for the performance 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 ain
a to the permit issuing office.
CHECK ONE: INSURANCE BOND 0 OTHER 0 Specify:
OWNER'S INSURANCE W IVER: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 0
Owner/Agent: Tel.No.:
Signature: Email.: