HomeMy WebLinkAboutBLDE-23-19046 7/3/23, 1:54 PM about:blank
Commonwealth of Massachusetts
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* Town of Yarmouth 0
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' ELECTRICAL PERMIT y'
Job Address: 26 ROSE RD Unit:
Owner Name: ELDREDGE THEODORE R OBRIEN SIOBHAN E
Owner's Address: 26 ROSE RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19046
Existing Service Amps/Volts Overhead ❑ Underground ❑ No.of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No.of Meters:
Description of Proposed Electrical Installation: Bath room exhaust fan
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 ❑ 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 0 Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: July 3, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: License Number:
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Fee Paid: $50.00
Email: Business Telephone:
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the
licensee provides proof of liability insurance including "completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
INSURANCE:
0 AI 6/26 6er:, eE
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Contnwnw.a44 a/Mmeachae.tte Official Use Only�p, I
• ' e •, c�77 C� Permit No. l�Z-3-- l t 0 t-4 (-0
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Occupancy and Fee Checked_S�Y3y
I• BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07) cleave blwk)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
G (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dote: 7—3—Z G 2 3
City or Town of: A 4r/tip v4-1, To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
i Location(Street&Number) 9. Be Sp Rom/•
Owner or Tenant 7j4ee•e/,r.,. ffs/ra,./f•{ Telephone No.77 -26$-/O0S
Owner's Address 26 £OSe Post Sevt, ye,te es/4-11 tryGst: 4,26et-I
N Is this permit in conjanclMs with a budding permit? Yes Er—No 0 (Check Appropriate Box)
Purpose of Building 3 L P 21.--a9 e I c'I UdNtyy Anthorlatlon No.
Existing Service Amps / Volts Overhead Er Undgrd 0 Nis.of Meters
)'4ew Service Amps / Volts Overhead 0 Undgrd El No.of Meters
l Number of Feeders and Ampacity
1•-• Location and Nature of Proposed Electrical Work: 84 H., rDOM tX h 4 d 'f FAn
v) Completion of the following �table m be waived by the/nsvector of Wires.
otal
lbNo.of Recessed Luminaires No.of Cell.�•�addle)Fans Tr.of T Transformers KVA
C1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Above In- No.of Emergency Lighting
d- No.of Luminaires Swimming Pool grod. ❑ grnd. ❑ Battery Units
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
1 1' No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
No.of Waste n Heat Pump Number Tons___I KW "No.of Self-Contained
Totals: I------1 -- Detection/Alertins Devices
a
No.of Dishwashers Space/Area Heating KW local❑M Connic palection 0 Other
Seca stems:*
4o.of Dryers Heating Appliances KW o.S y
No.of Devices or Equivalent
Ci 14o.of Water No.of No.of
LI•) W , Data Wiring:
N 2 Heaters Signs Ballasts No.of Devices or Equivalent
N C 'Jo.Hydrromamage Bathtubs No.of Motor Total HP 'TelecommunicationsNo.of Devices or Equivalent
m � L
w O A ITHER: B�fhrt,o, Ey1saQ ST �er"
I C9 [��7 Attach additional detail if desired or as required by the Inspector of Wires.
V = o jtittuted Value of Electrical Work: N'G 06 .00 (When required by municipal policy.)
ork to Start: 7-c-702-3 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
c l m SURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
he 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 Ellg BOND❑ OTHER t,pecify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:
Licensee: Signature LIC.NO.:
(Ifapplicabk,enter"exempt"in the license number line.) Bus.Tel.No..
Address: Alt.Tel No.:
*Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER: I ant aware that the Licensee does not have the liability insurance coverage normally
required�by�law. BByymmmyy s�/�tat rre be hereby w ' this requirement. I am the(check one)E owner 0 owner's agent.
Owner/Signature +A/7� /'•y���� l �" Telephone No.%i Y"Z b rt- PERMIT FEE:$
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