HomeMy WebLinkAboutBLDE-24-860 5/30/24,2:47 PM about:blank
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���(J Commonwealth of Massachusetts oF_. ,,, ,
* Town of Yarmouth ��.`
ELECTRICAL PERMIT :iiiik
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Job Address: 41 NORMAAVE Unit:
Owner Name: JORDAN LEONARD F JR TR
Owner's Address: 41 NORMAAVE Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-24-860
Existing Service Amps/Volts Overhead 0 Underground❑ No. of Meters:
New Service Amps/Volts Overhead 0 Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Permit to close expired permit from 3/28/18 E18-5350.
No.of Receptacle Outlets: 6 No.of Switches: 1 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-Grnd.❑ Above-Grnd.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 0 Ground-Mount❑ Level 1 ❑ Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: May 30, 2024
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: Fee Paid: $50.00
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:
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A Commonwealth of Massachusetts Official Use Only
Permit No.: r-�S{-e6 c
li,_, Department of Fire Services Occupancy and Fee Checked:
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1 BOARD OF FIRE 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 1 00
City or Town of: YARMOUTH Date: c 36
To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the electrical work d scribed below.
Location(Street&Number): '9/ N4) Unit No.:
Owner or Tenant: /,) / Email:.L At))c-4'0 0/74//.�COr1
Owner's Address: ,//i/OO 77,A AIX"✓-VAi2liDil725 14,4Phone No.: 7 7 Z6":1 4
Is this permit in conjunction with a building permit?(Check appropriate box)Yes 0 No❑Permit No.:
Purpose of Building: /L lrt,,j j Cs' Utility Authorization No.:
Existing Service: /DO Amps/ iJ/ 6 Volts Overheat Underground❑ No.of Meters:
New Service: Amps / Volts Overhead❑ Underground 0 No.of Meters:
Description of Proposed Electrical Installation: b(/I',4,= ' Sa17 ,t:j7 - 1 r9/1,
/17 Veel L161t--
Completion of the following table may be waived by the Inspector of Wires. d r Ii;i)ill grin; /- 8 t..D e—/S-—0DJ35(D
No.of Receptable Outlets: .. No.of Switches: / Generator KW Rating: Type:. -9V1i red liku/)i9
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-Gmd.0 Above-Gmd.❑ Hot-Tub❑ No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System ❑ No.of Devices:
No.AirConditioners: 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 Equ' t:
No.of Modules: Roof-Mount❑ Ground-Mount 0 Level 1 0 Level 2❑ Level 3 Rtip:C E I V E D
OTHER: ---.______---
Attach additional detail if desired,or as required by the Inspector of Wires. MAf 3 01Q24
Estimated Value of Electrical Work: (When required bl. tc C�
Date Work to Start: Inspections to be requested in accordance with MEC ulu 10,and upon com o i.
FIRM NAME: A-1 0 or C-1❑LIC.No.:
Master/Systems Licensee: LIC.No.:
Journeyman Licensee: LIC.No.:
Security System Business requires a Division of Occupational Licensure S"LIC. S-LIC.No.:
Address:
Email: Telephone No.:
I certify,undererQ the pains and penalties of perjury,that the information on this application is true and complete
�. Iriaortseever.it ezx ri Print Name: /s oii2.R27 ��,k ?i) Cell.No.: /c���-t�O3?7
INSURANCE COVE E:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee
provides proof of liability i luding"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 0
Owner/Agent: Tel.No.:
Signature: Email.: