HomeMy WebLinkAboutBLDE-23-15856 ti Commonwealth of Massachusetts o yam ' ,
Town of Yarmouth 0c .
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,ELECTRICAL PERMIT if
Job Address: 44 STUDLEY RD Unit:
Owner Name: LUCEY ANNE LUCEY PAUL
Owner's Address: 19 WALTON LN Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-15856
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground 0 No. of Meters:
Description of Proposed Electrical Installation: Job site meeting
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 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 ❑ Level 2 0 Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: May 17, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: Sean Levitt License Number: 697
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: 99 Columbus Avenue Dover New Hampshire 08320
Email: IeclSean@GMAILCOM Business Telephone: 603-749-5365
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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BUILDING Din -'ti' ::OARD OF FIRE PREVENTION REGULATIONS Occupancy I/0ncyandFeeCbk)
ay- ----- [Rev.1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
V All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
• (PLEASE PRINT IN INK OR TYPE ALL INFORMA77ON) Date: ,�/,_/2-ZS
City or Town of: yAvWk;��L1 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) 44 S}t l -cr ,r-d
rC. . Owner or Tenant Pbe(} ll J`„ P fo'_2, t_le 4,
v ��'f Jln"Z_ Telephone No.1 J
e. Owner's Address 7 Pork- vvv,ts-W. f}ttui_ Su 4-c. I STrrk..{n eir,,,‘ NH- 61885
Ice this permit in conjunction�w�i��th,a,•bmlding¢„olt? yes ❑ No ❑ 4Check Appropriate Box)
NPurpose of Building �}11C0..lit C (j4:.j Utility Authorization No.
Existing Service I Amps 20C/i 4j Volts Overhead✓❑' Undgrd❑ No.of Meters j
I New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
Number of Feeders and Ampadty
Location and Nature of Proposed Electrical Wont: h /4;nS j e(e c('r t t Min e a}iro
▪ w-i+,,, A '— .
yt Completion of the followin&table may be waived by the Inspector of Wires.
Ili No.of Recessed Luminaires No.of Cell-Snap.(Paddle)Fans No.of
St Transformers Total
callo.of Luminaire Outlets No.of Hot Tubs Generators KVA
4' No.of Luminaires Swimming Pool Above ❑ In-d. Ba❑ No.ofttery Emerg
Uuitaency Lighting
gra
• No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
_- No.of Switches No.of Gas Burners No of Detection and
Initiating Devices
To
It' No.of Ranges No.of Air Cond. Total No.of Alerting Devices
No.of Waste Disposers RfatPump Number Tons.__,KW No.of Self-Contained
Totals: _ .. .. ......._.
....... Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local Q CoMunnnectionicipal ❑t
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of Devices or Equivalent
Heaters No.of No.of Data Wiring:
Signs Ballasts No.o evices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: 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 ieBOND❑ OTHER❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application it true and complete.FIRM NAME: X- ✓Il �-_SetIrr 1,L.`. Co Ai,!l Arm/'---. LIC.NO.: w P 7 14(-
Licensee: Signature
(If applicable,enter" 'in the l ffenrs maaber line. ,�'u Tel. o..NO(?n3-7+7�" (pJ�
Address: YY LU(.UHiklit (�(SJYe— iv, Bus.Tel.No r• Alt.Tel.No.:
'Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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. 1 am the(check one)❑owner ❑owner's agent.
Owner/Agent
Signature - - .• Telephone No. PERMIT FEE:$ ,Rs-0—
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