HomeMy WebLinkAboutBLDE-23-15933 5/24/ i,3:14 PM about:blank
Commonwealth of Massachusetts , Y.
wi!or Town of Yarmouth ,,. 0
O y
ELECTRICAL PERMIT �` f
Job Address: 34 LORENA RD Unit:
Owner Name: BOLAND JOSEPH J JR BOLAND CAROLINE
Owner's Address: 25 CEDAR CREST LN Phone: Email:
Purpose of
Building Residential Utility Authorization No.: 1
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-15933
Existing Service Amps/Volts Overhead ❑ Underground❑ 4./ No. of Meters/New Service Amps/Volts Overhead 0 Underground❑ , No.of Me,'be s•
Description of Proposed Electrical Installation: Service upgrade .,,,
w`'6 4�'
No.of Receptacle Outlets: No.of Switches: Generator KW Rating: Type: , `
No. Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Ratin • it.:qp.'z '
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 ❑ 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 1 0 Level 2 0 Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: May 24, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: JOSEPH P ROSE License Number: 21335
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: WEST YARMOUTH, MA, 026733367 WEST YARMOUTH MA
026733367 Fee Paid: $50.00
Email:jrose21335@gmail.com Business Telephone: 774-353-7526
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:
1/1
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cD
' RECEIV-
MAY 24 Zan o wealth of Massachusetts official use on1
Permit No.:i�23— lc 33
etih= RI a ment of Fire Services Occupancy and Fee Checked:
=e1-�1 1 GUEPA
-_11_-- 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) 5 7 C 12.00
City or Town of: YARMOUTH Date: ')�.Z- fib,3
To the Inspector of Wires:By this application,the undersigned gives nottiicees�of his or her intention to perform the electrical work °scribed below.
Location(Street&Number):_�j y I--C (4. yl Ot, 1 f Unit No.:
Owner or Tenant: 3-"oe_ePn aevi-ak 'S K. Email:
Owner's Address: Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes 0 No,afermit No.:
Purpose of Building: Utility Authorization No.:
Existing Service: _ Amps / Volts Overhead 0 Underground 0 No.of Meters:
New Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:
. Description of Proposed Electrical Installation: C.YJ\e .4. (J)05 reue�Z
Completion of the following table may be waived by the Inspector of Wires.
No.of Acceptable 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.0 Above-Gmd.❑ Hot-Tub 0 No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices:
No.Mr 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 0 Ground-Mount❑ Level 1 0 Level 2❑ Level 3 0 Rating:
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy)
Date Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: A-1 0 or C-1 El LIC.No.:
Master/Systems Licensee: b e L j Q\ , 7`ci,c LIC.No.:,11.g c R
Journeyman Licensee: �� '° LIC.No.: )' 9 13
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: o`IS fS cv c-rl It.Q,_ W V oe,--,pw��k Q?.-(o�3
Email: . .COSG a.133-i e, etN"�G.,1 ,(Air
Telephone No.:
I certify,under the pains and penalties of perjury,that the information on this application is true and complete
Licensee:—Sp. Pve Print Name: -SO5 ce-, P fee, C Cell.No.: 1,4'3 1s.A�
INSURANCE C VERAGE: nless waived by the owner,no permit fo?the performance ofelectrical 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 0 Owner's agent❑
Owner/Agent: Tel.No.:
Signature: Email.: