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HomeMy WebLinkAboutBLDE-23-15902 • _..—r Commonwealth of Massachusetts =o� • Y — * Town of Yarmouth � „ � ELECTRICAL PERMIT k Job Address: / LI 4 p U- � Unit: q6y �33-878 Owner Name: Li4-'JQ-A P Ni I CS/ Owner's Address: Phone: Email: Purpose of Building Residential Utility Authorization No.: Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-15902 Existing Service Amps/Volts Overhead 0 Underground❑ No.of Meters: New Service Amps/Volts Overhead ❑ Underground 0 No.of Meters: Description of Proposed Electrical Installation: install light fixture &socket on farmers porch (508-333-8789) No.of Receptacle Outlets: No.of Switches: Generator KW Rating: ,.Type: -N> 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.0 Above-Grnd.❑ Hot Tub 0 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 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 0 Level 2 0 Level 3❑ Rating: Estimated Value of Electrical Work: $ 0 Work to Start: May 22, 2023 FIRM NAME: License Number: Master/System and/or Journeyman Licensee: License Number: Security System Business requires a Division of Occupational Licensure "S" LIC. License Number: Address: Email: Business Telephone: 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: I3-k ( JJ ql7h7Z3 RECEIVED —.-,--e—'-,1„ tcial Use Only _= MAY 2 " n ealth of Massachusetts Permit No.: <7G 'Z3 /S i D Ay!==; Dep iment of Fire Services Occupancy and Fee Checked: f°I--= ,BOAR AO '°' I11: PREVENTION REGULATIONS ( ] Rev. 1/2023 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527 CMR I2.00 City or Town of: YARMOUTH • Date: To the Inspector of Wires:By this ap lication,the undersigned Ives notices of his or her intention to perform the electrical work described below. Location(Street&Number): 4� 0UJP5 ROB S. `I)cur r 1 O\ Unit No.: Owner or Tenant: I-au r C.. MQ Email: rnt�1J(,,bc f O a t� O . corn Owner's Address: LI Lt (40 L)QS QOC1 S �{an O t Phone N'o.: SOS-. 3- 1 89 Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No❑ Permit No.: Purpose of Building: Utility Authorization No.: Existing Service: Amps / Volts Overhead❑ Underground El No.of Meters: New Service: Amps / Volts Overhead El Underground❑ No.of Meters: Description of Proposed Electrical Installation: `t _U\A f N K-1-\)re, 4 S G GllQ4' ©It t r'CtC ArlaS ?ocd\ Completion of the following table may be waived by the Inspector of Wires. 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❑ No.of Devices: Swimming Pool:In-Grnd.El Above-Gmd.❑ 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❑ 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 El Ground-Mount El _ Level 1 ❑ Level 2 0 Level 3 0 Rating: OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy) Date Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. FIRM NAME: A-1 0 or C-1 0 LIC.No.: Master/Systems Licensee: LIC.No.: Journeyman Licensee: LIC.No.: Security System Business requires a Division of Occupational Licen:,ure"S"LIC. S-LIC.No.: Address: Email: Telephone No.:_ I certify,ani er the pains a d penalties of perjury,that the it formation on this application is true and complete. I ,, Li> Wee ,LL(.kLt Print Name: LCCU/Gt. nil endc SGL Cell.No.: 508-333 ?7 t INSURA 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❑ OTHER❑ 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❑ Owner/Agent: Tel.No.: Signature:_ Email.: