HomeMy WebLinkAboutBLDE-23-16033 6/8/73F-2:59 PM about:blank
, v Commonwealth of Massachusetts o YAK.
*w Town of Yarmouth
0
c 0 ' *-1'c ELECTRICAL PERMIT �A . )
Job Address: ( 2 LL c Cfc_c --it 4d.-E-
Owner Name:
Owner's Address: Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-16033
Existing Service Amps/Volts Overhead 0 Underground ❑ No. of'Meters:
New Service Amps/Volts Overhead 0 Underground El ts.:•.of >/
Description of Proposed Electrical Installation: Wire & bonding for pool.
7t.d.
No.of Receptacle Outlets: No.of Switches: Generator KW Rating: fi'-rO
Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rat .: 8V G/Q*P—
No. �
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA:
Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW: I4,
No. Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of Devices:
Swimming Pool: In-Grnd.0 Above-Grnd.❑ Hot Tub El 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❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 5,000 Work to Start: June 7, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: PAUL J PETERSEN License Number: 14110
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Mashpee, MA, 026492366 Mashpee MA 026492366 Fee Paid: $150.00
Email: pjpetersen@gmail.com Business Telephone: 774-836-5407
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-1-3AIL - G-4,ONO L 144-- * CO\D1J1, 0)74 275 M.
,01-1-h q-NuNoot 7 i4
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t; . Occupancy and Fee Checked
__ ii''� BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
CI APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION)
City or Town of• �� ( m t Date: 6 23
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) 3I (3 I , 5 C Cat-}- Ave
Owner or Tenant \c.0 i(A, 0( l i �C i CO-
I Telephone No.
0 Owner's Address 31 61 5 Co f- A ye_ S. Ya r m out h M A n L(o Co 4
wi Is this permit in conjunction with a building permit? Yes [ } No ❑ (Check Appropriate Box)
L Purpose of Building S i n v l e. 4 c.en i I..j J u)e 11.(k5 Utility Authorization No.
.6. Existing Service ZO b Amps 12 U/ 211(2 Volts Overhead 0 Undgrd 0' No.of Meters
1
°) New Service Amps / Volts Overhead❑ Undgrd ❑ 1NR0EGrE V_r D tv
Number of Feeders and Ampacity Eoo A 3 W rc---
4' Location and Nature of Proposed Electrical Work: (3 U n d t w i re Pao I 1 J U N 08 21123
Completion of the followingtable may be a -elm; —Avector of Wb et.1
v+ No.of L i3y _,-Total
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers--KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
KN. Above In- 'No.of Emergency Lighting
No.of Luminaires Swimming Pool grnd. ❑ 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
y Initiating Devices
Total
11 No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
Disposers Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Dis
Po Totals: Detection/Alerting Devices
Municipal
No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other
Heating Appliances KW ''Security Systems:*
No.of Dryers No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaters KW Signs Ballasts No.of Devices or Equivalent
Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: li Si 000 .00 (When required by municipal policy.)
Work to Start: (o/ 7/ 2 3 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 cove ge is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE 'BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: O A RM, I J - Perferse n ce(S�J?ed'JL,ll eci—r-� c , c&r\ LIC.NO.: (L( I 1 O 6Licensee: Pak)l J • Pe4 e(Se . Signature 1/ / " .---7 LIC.NO.:
(if applicable,enter "exempt"in the license number line.) Bus.Tel.No.: 774• 2 307.5 t-1 01
Address: 13 5 h i CI d S ft o' M co h pee 0 2-6 4 C1 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 Telephone No. PERMIT FEE: $
Signature