HomeMy WebLinkAboutBLDE-24-668 4/25/24,7:05 AM about:blank
Commonwealth of Massachusetts og Y
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* Town of Yarmouth 3�� :, c
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ELECTRICAL PERMIT A f)
Job Address: 43 POND ST Unit:
Owner Name: RUBIN BLAKE J
Owner's Address: 96 RICHMOND AVE Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-24-668
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Wiring for wall heater&3 smoke/CO detectors.
No.of Receptacle 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.❑ 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 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❑ Level 1 0 Level 2 0 Level 3❑ Rating:
Estimated Value of Electrical Work: $ 2,700 Work to Start: April 24, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: DESMOND P CLIFFORD License Number: 33276
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: W YARMOUTH, MA, 026734853 W YARMOUTH MA 026734853 Fee Paid: $50.00
Email: desmondclifford@gmail.com Business Telephone: 617-872-0008
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the
licensee provides proof of liability insurance including "completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
INSURANCE:
W-.(5 Lk (zi?/zq £
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.RECEIVED
I.TJ i it �.It
ommonwealth of Massachusetts Official Use On
Permit No.: — j
02� Department of Fire Services Occupancy and Fee Checked:
_C_`el- + Rev. /2023]
.-_t __- . D OF FIRE PREVENTION REGULATIONS
BUILri: _=i—
BY '.= ' A - ' (CATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 5 7 M 12.00
City or Town of: YARMOUTH _ Date: 2 - JJ/-.
To the Inspector of Wires: By this application,tj'e undersigned gives notices of his or her intention to perform the electric work escribed below.
Location(Street&Nu er): T ®oNO s'7 - Unit No.:
Owner or Tenant: 1$.0 ct Z Email:
Owner's Address: 9 4 /Z Ik" O I a SiP- /1'Z 0 i6 ti2— Phone No.: cbg 713 22-23
Is this permit in conjunction with a building permit?(Check appropriate box) Yes❑ No E Permit No.:
Purpose of Building: I l 0' ti' ' Utili Authorization No.:
Existing Service: j 00 Amps ►ZV / 21w Volts Overhead Underground ❑ No. of Meters: l
New Service: f.1 A" Amps / Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: //Tar I -2 000 4inr 2 clo 416-T..
4014-0 41.4c .{- V\thOlit "5-446-- --1- -21-12101et-/ -o .0eT rrna-C.. Wei&
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: 2. 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.❑ Above-Grnd. ❑ 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 ❑ 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 as required by the Inspector of Wires.
Estimated Value of El ct ical ork: Z700 (When required by municipal policy)
Date Work to Start: 2 2}� Inspections to be requested in accordance with MEC Rule 10, and upon completion.
FIRM NAME: 1110 0 / CC Z A-1 ❑or C-1 [i1C. No.: "3T2-7 ( •
Master/Systems Licensee: LIC. No.:
Journeyman Licensee: 06A044 P Ci•;f--4J LIC. No.:
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: I �%X -7ff/L4p0//N� /O J Y£ l `Ay4.,0 mg 02/7D
O Email: I AA1 C tX.A /�O(4 Pljt • M-- _ Telephone No.:(T) '72- 0oD 7`
I certify, under the pains and penalties
s n
of perjury, that the information on this application is true and complete.
Licensee: 0 rrfD f C/ `M) Print Name: 1JC4 ,"0 P (I Il i Cell.No.: 6-7) 9-7Z°VcP
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 s e to the permit issuing office.
CHECK ONE: INSURANCE (BOND ❑ OTHER❑ Specify: .i¢1-117 ..rJsi-4 to
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.:
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