HomeMy WebLinkAboutBLDE-23-19025 6/28/23,3:46 PM about:blank
. Commonwealth of Massachusetts of • Y:� "
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Town of Yarmouth 3 0 .
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, ELECTRICAL PERMIT 'c''‘ ,-I
Job Address: 63 ELDRIDGE RD Unit:
Owner Name: MOYNIHAN JOHN F II MOYNIHAN ERIN K
Owner's Address: 122 GREATON RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19025
Existing Service Amps/Volts Overhead ❑ Underground❑ No.of Meters:
New Service Amps/Volts Overhead ❑ Underground❑ No.of Meters
Description of Proposed Electrical Installation: @nd floor renovations
No.of Receptacle Outlets: 20 No.of Switches: 11 Generator KW Rating: L,Type: %"r,/
No.Luminaires: 4 No.of Recessed Luminaires: 12 No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: 1 KW: No.Transformers: Total KVA: V
Space Heating KW: Heating Equipment KW: No. Motors: Total HP: Total KW: wv(
No. Heat Pumps: 1 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 0 Ground-Mount❑ Level 1 0 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: DAVID W SPRINGER License Number: 13239
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: HYANNIS, MA, 026012106 HYANNIS MA 026012106 Fee Paid: $75.00
Email: springz1212@comcast.net Business Telephone: 508-364-0139
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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RECEIVED
'r 1, 023 Official Use Only,
ommonwealth of Massachusetts �7.3_ C)Z.,Permit No.:
Mil,ill '. Department of Fire Services Occupancy and Fee Checked:
BUIU - .• a AKII OF FIRE PREVENTION REGULATIONS [Rev.1/2023]
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APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),52,7 C R 12.00
City or Town of: J YARMOUTH Date: (vI Z g IZ-3
To the Inspector of Wires:By thi lication,the undersigned gives notices of Isis or her intention to perform the electrical work described below.
• Location(Street&Number): E 1,)c Co . C Unit No.:
Owner or Tenant: 7rkch ]✓�o q os, O rt •J Email: -j1'Owner's Address: J eNo.: { 353 GTZ S
Is this permit in conjunon with a building permit?(Check appropriate box)Yes No❑Permit No.:
Purpose of Building: al 4.r1\\;tI Utility Authorization No.:
Existing Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:
New Service: Amps / Volts Overhead 0 Underground❑ No.of Meters:_.c.Description of Proposed Electrical Installation: &a1 vsh �` �i c\C S�1 I.,)1 Ue 5���S Sti
Completion of the following table may be waived by the Inspector of Wires.
No.of Receptable Outlets: ZO No.of Switches: l Generator KW Rating: Type:
No.Luminaires: l No.of Recessed Luminaires: \'L, No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: KW: 1 No.Transformers: Total KVA:
Space Heating KW: Heating Equipment KW: l No.Motors: Total HP: Total KW:
No.Heat Pumps: tf Z Total KW: Total Tons: Fire Alarm System❑ No.of Devices:
Swimming Pool:In-Gmd.0 Above-Gmd.❑ 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❑ 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❑ Ground-Mount 0 Level 1❑ Level 2❑ Level 3 0 Rating:
OTHER:
Attach additional detail if desired,or a required by the Inspector of Wires.
Estimated Value of Electrical Work: 45 1 Ur 0 cJ& (When required by municipal policy)
Date Work to Start:Ce I Z7 7-2) Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: SQ C i r.bek G r k ck c i A-1❑or C-1 0 LIC.No.:
Master/Systems Licensee: Se,,,6-,e- gi 1.c�((. LIC.No.: Z 10 1 C R
Journeyman Licensee: \T t ;D Secs' t1 LIC.No.: (3 ZSq g
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: 10 (,,-)‘-‘des \--tc. an too) 2 q
Email: S f e t R6.'2- 1-Z.1-ZQ ( m J o o c Sk , e Telephone No.: c68 (y 3!0(
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
Licensee: Oce.,Z 3(pc i n Print Name: -pc,/ C ki r Cell.No.: �0$ 5sc i O C 31
INSURANCE COVERAGE: nless waived by the owner,no permit for the perform ce of electrical work may issue unless the licensee
provides proof of liability including"comple operation"coverage or its substantial equivalent.The undersigned certifies that such coverage
is in force and has exhibited proof of s to the permit issuing office.
CHECK ONE: INSURANCE BOND❑ 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 0 Owner's agent❑
Owner/Agent: Tel.No.:
Signature: Email.:
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