HomeMy WebLinkAboutBLDE-23-18974 6/21/23,5:54 AM about:blank
Commonwealth of Massachusetts oii` y�
* Town of Yarmouth . •%
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ELECTRICAL PERMIT xla
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Job Address: 60 BEVERLY RD Unit:
Owner Name: MASSA STEPHEN A TRS MASSA ROBERT F TRS
Owner's Address: 22 HILLCREST RD Phone: Email:
Purpose of
Building Residential Utili Authorization No.:
Is this permit in conjunction with a building permit? No Per 4 er: BLD - -18974
Existing Service Amps/Volts Overhead ❑ Underground❑ r
New Service Amps/Volts Overhead 0 Underground ❑ 4JI Description of Proposed Electrical Installation: Rewire furnace /vn Jl
No.of Receptacle Outlets: No.of Switches: Generator KW Rating: Type
No.Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating:
iN
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA: J`U//J)
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: 0 Video System 0 No.of Devices:
No.Air Conditioners: Total Tons: Telecom System D 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 0 Level 1 0 Level 2 0 Level 3 0 Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: June 14, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: ADAIR MARTINS License Number: 23369
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: OSTERVILLE, MA, 02655 OSTERVILLE MA 02655 Fee Paid: $50.00
Email: info@mrcapeelecrician.com Business Telephone: 508-301-2655
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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Commonwealth of Massachusetts Official Us Permit No.: C-z3-1'0"/7q
rr! ' Department of Fire Services Occupancy and Fee Checked:
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'` BOARD OF FIRE PREVENTION REGULATIONS [Rev.I/2023]
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 2.00
City or Town of: YARMOUTH Date: i 6!7 Ci/oZ�
To the Inspector of Wires:By this application,the undersigned gives noti s of his or her intention to perform the electrical work described below.
Location(Street&Number): tjO . A2s 1 li rt- Unit No.:
Owner or Tenant: .SY-0. i ki q S Email: S trI Lr SSc0.$3 vet Ll UG t1iM
Owner's Address: E tj A - Phone No.:q i- -'ES- - 5-}cj}
Is this permit in conjunction with a building permit?(Check appropriate box)Yes 0 No Ly Permit No.:
Purpose of Building: Q .S;Of Q i 4z-4..A Utility Authorization No.:
Existing Service: Amps / Volts Overhead 0 Underground 0 No.of Meters:
New Service: Amps / Volts Overhead 0 Underground 0 No.of Meters:
Description of Proposed Electrical Installation: I1Q-Gti`,:se cal C-L,v n'aC e_ M 6,seal 1- kz)
r t' aid n+ }vi 61 wts;d e., LA, -
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.❑ Above-Gmd.0 Hot-Tub❑ No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System 0 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 0 Ground-Mount❑ Level 1 0 Level 2 0 Level 3 0 Rating:
OTHER:
Attach additional detail if desired,or 7 rrxquired by the Inspector of Wires.
Estimated Value of Electrical Work: Li 00 (When required by municipal policy)
Date Work to Start: 06)i 14I2 3 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: (1,'R.Crll e - xi-nn , �r Art LLC. A-1❑or C-1 El LIC.No.:
Master/Systems Licensee: yp�,;c 1�6t.f ivt S l 2 LIC.No.: D.33 6 t �t'— t 1
Journeyman Licensee: am i.r4 C t'& s 4Z LIC.No.: 6 3.:2, — 1�
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: ,Z lb (..4;fYI CYtU 1Yt(en hir, t/5).4-ti UN)t t 2 H 'H y t n r S (l AL n9.6Q)
Email: 1 n TJ e YY1,f C etti3e t'.te±f-i Cn r'trn . GU CM. Telephone No.: 02-a.))-2 655
I certify,under the pains and penalties of perjury,that the inf rm ion on this applicationl is true and complete.
Licensee: i) ,tf- (4 - '.&.3 Print Name: , 2�� - � /`�rc-tr-Fell.No.: SOY-ZTIS- E I' 3
INSURAN E COVERAGE:Unless waived by the owner,no permit for the performance of 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 of spit
to the permit issuing office.
CHECK ONE: INSURANCE BOND 0 OTHER 0 Specify:
OWNER'S INSURANCE WAIVER:I am aware that the Licensee does not have the liability insurance coverage normally
required by law.By my signptgr UeIc ol,>Sheie{ly v ivrjh s requirement.I am the:(Check one)Owner 0 Owner's agent 0
Owner/Agent: t ... t _ _� _ Tel.No.:
Signature: 1 Email.:
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1 BUILDING utr'NR1 MENT
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