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HomeMy WebLinkAboutBLDE-23-20014 12/12/23,3:12 PM about:blank Commonwealth of Massachusetts o • Y4 * Town of YarmouthV# 0 ELECTRICAL PERMIT � f Job Address: 22 UNION ST Unit: Owner Name: MAHFOUZ NASSIB Z Owner's Address: 432 MAIN ST Phone: Email: Purpose of Building Residential Utility Authorization No.: Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-20014 Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters: New Service Amps/Volts Overhead❑ Underground❑ No. of Meters: Description of Proposed Electrical Installation: In-Ground pool 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 El 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❑ Ground-Mount❑ Level 1 Cl Level 2❑ Level 3❑ Rating: Estimated Value of Electrical Work: $ 3,000 Work to Start: December 12, 2023 FIRM NAME: License Number: Master/System and/or Journeyman Licensee: Douglas J Ahaesy License Number: 20925 Security System Business requires a Division of Occupational Licensure "S" LIC. License Number: Address: North Dartmouth, MA, 027471344 North Dartmouth MA 027471344 Fee Paid: $135.00 Email: ahaesyelectric@comcast.net Business Telephone: 508-726-0660 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: (--()C)U t).) 3 f 2 3 ?/ / about:blank 1/1 .;. CommonivealL o/Mcwachusati3 Official Use Only �=- - �23 2©t'J 144 c7 Permit No. '*;�* .2uparlmsnt o/.Jira.srvicss r 0- a' Occupancy and Fee Checked of BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) (leave blank) v-.0 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ln All work to be performed in accordance with the Massachusetts Electrical Code EC),527 CMR 12.00 cr (PLEASE PRINT IN INK OR TY E ALL INFORMATION) Date: /67. /0/:,702-3 City or Town of: ! `•t r r^')b t,\1 L To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Q Location (Street&Number) n (AvV)0 i\ -S'"I-. U Owner or Tenant Ai a S-S \ D (11.Cat\,\.V CU Z Telephone No. L Owner's Address F j Is this permit in conjunction with a building permit? Yes P No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd I I No.of Meters New Service Amps / Volts Overhead _ Undgrd No.of Meters d Number of Feeders and Ampacity �I Location and Nature of Proposed Electrical Work: l J 1 l t AS -�.�c,r^ Li t r,kJ I .ti-' G (C L�t� 'PGU , V) Completion of the following table may be waived by the Inspector of Wires. Q.) No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of otai Transformers KVA CI No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grnd. grnd. IN 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 No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: ,Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local L Municipal ❑ Other Connection No.of Dryers Heating 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.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 lectrical Work: -iO00. Gp (When required by municipal policy.) Work to Start: /U Zii 23 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VERAGE: 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 g). BOND ❑ OTHER ❑ (Specify:) 1 certify, under the pains and penaltie o perjury,that the information on this application is true and complete. FIRM NAME:-V)Ock C,S\ Il C,tesy /� LIC.NO.: "2CgZS4 Licensee: fl C^C� \� 5 �A eS/ Signature 0Q- Cf LIC.NO.:.S'U 3 I O 6 tlf applicable,enter' xem t';in the license umber line.) w``'' Bus.Tel.No.:.SQ -7Z&-0 660 Address: L' d .�t erCe , Oarr-^,pc\4\.y M/� 0 Z-?-L( -- 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 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. Owner/Agent Signature Telephone No. PERMIT FEE: $