HomeMy WebLinkAboutBLDE-23-19028 6/28/23,4:03 PM about:blank
', Commonwealth of Massachusetts
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*4 Town of Yarmouth �3 ,Y '
ELECTRICAL PERMIT
Job Address: 10 BREEZY POINT RD Unit:
Owner Name: PARE TODD
Owner's Address: 10 BREEZY POINT RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19028
Existing Service Amps/Volts Overhead ❑ Underground 0 Nor-of,Meters:
New Service Amps/Volts Overhead El Underground 0 .0. of Meters;
Description of Proposed Electrical Installation: Renovations basement, laundry room, bathro tid L l .
f witches: Generator KW Rating: Ty
No.of Receptacle Outlets: No.o S �f,, V/O�
No.Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating: a ® /
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: 4P. 1
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 El 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 ❑ Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: June 28, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: STEPHEN M CHILDS License Number: 32325
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: MARSTONS MLS, MA, 026481519 MARSTONS MLS MA
026481519 Fee Paid: $75.00
Email: stevechilds39@yahoo.com Business Telephone: 508-280-9018
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the
licensee provides proof of liability insurance including "completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
INSURANCE:
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ommonwealth of Massachusetts Ci'jofficial use onlIy�
- 23 Permit No.: 3" [`%O Z n
Department of Fire Services Occupancy and Fee Checked:
Min_ R OF FIRE PREVENTION REGULATIONS [Rev.1/2023]
(CATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12..20
City or Town of: YARMOUTH Date: t' /1$ /d 3
To the Inspector of Wires:By this applica'on the u gives nohces,00f by or her intention to perform the electrical work described below.
Location(Street&Number): / ee Pa 1 trl /wit Unit No.:
Owner or Tenant: /04 , ei Email:
Owner's Address: fa,rfl Phone No.:.5-d g 3CG`G/33'
Is this permit in conjuncp with a building permit?(Check appropriate box)Yes❑ No 0 Permit No.:
Purpose of Building: �4.07•
_•/%�{✓-e/l,s Utility Authorization No.:
Existing Service: /6 O Amps2 3//. Volts Overhead['Underground 0 No.of Meters: V
New Service: Amps / Volts Overhead❑ Underground No.of Meters:
. Description ofPropoWA;
edd da Electrical Installation: 4./Y-e//if'/C4-/M./2z,vt! Ides/ /p /.futw- 'eV
�!J/I!h yL' '/� eii+Y�/.X?'.,.to A/J .2l G. ly�e� , /-. !Q /2 erS sla/
Completion of the following table may be waived by the Inspector of Wires. C C r 1 t n r
No.of Receptable 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 0 No.of Devices:
Swimming Pool:In-Grad.0 Above-Gmd.0 Hot-Tub 0 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❑ 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❑ Level 2❑ Level 3❑ Rating:
OTHER:
Attach additional detail if desired,or a quired by the Inspector of Wires.
Estimated Value of Electrical Work: 6-4 Ud 0, (When required by municipal policy)
Date Work to Start: 4/aCs/.2i Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: f'4pit.1 6,h,Le," A-1❑or C-1-6LIC.No.:
Master/Systems Licensee: t LIC.No.:/- I.,/302,1
Journeyman Licensee: ,.C.4")dr4 C/7 I .h/ LIC.No.:
Security System Business requires a Division of Occupationalio Licensure"S"LIC. S-LIC.No.:
Address: /4/C Cam,//? fC � ' 4*.e.5-20f 4fi/ ..ul d 6a76 S!-
Email: S 24JC CA [.X>S 3 r 4/ J 64 ,, , G dr T Telephone No.:
I certi,under the pains and penalties of perjury,that the Information on this application is true and complete.
Licensee: SW/view C 7 d hS' Print Name: StLrel c,9 Ch, (- Cell.No.:3"6 g 07nd-rd/g
INSURANCE 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 same 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 signature below,I hereby waive this requirement.I am the:(Check one)Owner❑ Owner's agent 0
Owner/Agent: Tel.No.:
Signature: Email.: C/C-4-/33
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