HomeMy WebLinkAboutBLDE-24-934 'AM about:blank
Commonwealth of Massachusetts of ?*
Town of Yarmouth
ELECTRICAL PERMIT MMTACHGESC
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Job Address: 73 CAPT WRIGHT RD Unit:
Owner Name: ST GEORGE MARY BETH TR
Owner's Address: 73 CAPT WRIGHT RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-24-934
Existing Service Amps/Volts Overhead ❑ Underground 0 No. of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Bath room renovations
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 ❑ 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:
Estimated Value of Electrical Work: $ 1,500 Work to Start: June 11, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: JARLATH A GALVIN License Number: 10861
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Yarmouth Port, MA, 026752045 Yarmouth Port MA 026752045 Fee Paid: $75.00
Email:jargalvin@comcast.net Business Telephone: 508-488-7487
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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Commonwealth ,� f Official,Use nl
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_- Permit No.:
I -_� � - ft Department of Fire Services Occupancy and Fee Checked:
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�..�= = _ = .. REGULATIONSRev. 1/2023]
- 1_f BOARD Or FIRE PREVENTION
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC)\ ,tctc
527 CMR112.00
City or Town of: YARMOUTH _ • Date: t1� 24
To the Inspector of Wires: : this . : • Iication, the undersigned gives notices of his or her intention to perform the elec ical work described below.
Location (Street & umb " : CAT/ t Rt 6i111 SI Unit No.:
Owner or Tenant: baQtt St- 6-F Email:
Owner's Address: Phone No.: so g ' -2 ‘62, ,
Is this permit in conjunction with a building permit? (Check appropriate box) Yes IdNo LI Permit No.:
Purpose of Building: ocr E Utility Authorization No.:
Existing Service: Amps / Volts Overhead LI Underground LI No. of Meters:
New Service: Amps / Volts Overhead LI Underground LI No. of Meters:
Description of Proposed Electrical Installation: _ Ott e , • 000
: . „,
.... , i . a
Completion of the following table may be waived by the Inspector of Wires. JUN
1120 24 .
No. of Receptable Outlets: No. of Switches: Generator KW Rating: yp :
No. Luminaires: No. of Recessed Luminaires: No. Wind Generators: Wind KW ' aOg[DING DFPAR
TMCNT
No. Appliances: KW: No. Water Heaters: KW: No. Transformers: Tot. F %14 _______________.�__
Space Heating KW: Heating Equipment KW: No. Motors: Total HP: Total KW:
No. Heat Pumps: Total KW: Total Tons: Fire Alarm System El 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 ❑ Ground-Mount 0 Level 1 ❑ Level 2 ❑ Level 3 ❑ Rating:
OTHER:
Attach additional detail if desired, or required by the Inspector of Wires.
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Estimated Value of Electrical Work: ' 1 5' (When required by municipal policy)
Date Work to Start: ;��. tk 2-01 Inspections to be requested in accordance with MEC Rule 10, and upon completion.
FIRM NAME: - IN1,C, -`tl`(, 6-111.:vit• A- 1 ❑ or C- 1 a LIC. No.:
Master/Systems Licensee: LIC. No.:
Journeyman Licensee: '"�'t C7rL- 1I NY ����� � LIC. No.: 16 tbl. c' ,.
Security System Busine s requires a Division of Occupational Licens re "S" LIC. S-LIC. No.:
Address: &Lib ku t-,VI _ 6kk
AiRavlOttiti iv"
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Email: I a <, p. lV 11•S eic <rL. )ct Telephone No.: c--408. a
I cer4ifyrunle, , ains R d penalties of perjury, that the information on this application is true
and complete.
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Licensee: is 71 - a VIN Print Name: /Z 5'4- 1N Cell. No.: $
1.04 -19 :V?---
INSURANC ; COVER GE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee
provides proof e f 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 LI BOND ❑ OTHER LI 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 LI Owner's agent LI
Owner / Agent: Tel. No.:
Signature: Email.: