HomeMy WebLinkAboutBLDE-23-15827- Commonwealth of Massachusetts .cc ' v-44
*UTown of Yarmouth w* c
ELECTRICAL PERMIT
Job Address: 2-7 3 crq r ow A tt Unit:
Owner Name: (-{-A-IJ t rr; Pu, a'1 _
Owner's Address: Phone: Email:
Purpose of
Building Commercial Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-15827
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground 0 of Meters:
Description of Proposed Electrical Installation: Power wiring for new irrigation well.
No.of Receptacle Outlets: No.of Switches: Generator KW Rating: !
No. Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wlnd KW Riti�
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: TotalKVA:
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: ,, p '
Vf
Swimming Pool: In-Grnd.❑ Above-Grnd.0 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❑ Ground-Mount❑ Level 1 0 Level 2 0 Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1,000 Work to Start: May 15, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: Sean Reilly. License Number: 22960
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: 110 Old Town House Road South Yarmouth MA 02664
Email: sventura@gorelco.com 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:
RECEIVED
4:. MAY 121iinram onwealth of Massachusetts Official Use Only
Permit No.:
e
_ tiif .AiG LitPARTM qirtment of Fire Services Occupancy and Fee Checked:
�` •, _ e ' ==—_ 'RE 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 12.00
City or Town of: South Yarmouth Date: 5/12/2023
To the Inspector of Wires: By this application,the undersigned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): 273 Station Avenue Unit No.:
Owner or Tenant: Hallett Funeral Home Email:
Owner's Address: 273 Station Ave. -South Yarmouth, MA 02664 Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No® Permit No.:
Purpose of Building: Commercial Utility Authorization No.: n/a
Existing Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:
New Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:
Description of Proposed Electrical Installation: Power wiring for new irrigation well.
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.❑ Above-Grnd.0 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 I ❑ Level 2❑ Level 3 0 Rating:
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: $1000.00 (When required by municipal policy)
Date Work to Start: 5/11/2023 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: Reilly Electrical Contractors, Inc, A-I ®or C-I 0 LIC.No.: 556
Master/Systems Licensee: Sean M. Reilly LIC.No.: 22960 A
Journeyman Licensee: LIC.No.:
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: 110 Old Town House Road-South Yarmouth, MA 02664
Email: sventura@gorelco.com Telephone No.: 508-619-9026
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
Licensee: � -N, �"�"`• Print Name: Sean M. Reilly Cell.No.: 508-400-8936
INSURANCE COVERAGE: 1Jnle; valved by the owner,no permit for the perlbrmance of electrical work may issue unless the licensee
provides proofof liability including"completed operation.'coverage or its substantial equivalent.The undersigned certifies that such coverage
is in lbrce and has exhibited proofof same 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❑ Owner's agent❑
Owner/Agent: Tel.No.:
Signature: Email.: