HomeMy WebLinkAboutBLDE-24-955 6/18/24,7:37 AM G ,re about:blank
. 1,1;.1\- Ca Commonwealth of Massachusetts Prof Y`9�4 ;
Vwr Town of Yarmouth ,'�� .: y
"it ELECTRICAL PERMIT '1/4 /,i,COR AGMC[8`b�q^
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Job Address: 7 MALLARD ST Unit:
Owner Name: FOULDS D RANDOLPH
Owner's Address: 7 MALLARD ST Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-24-955
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground 0 No. of Meters:
Description of Proposed Electrical Installation: Un-permitted renovations to be corrected/removed.
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: ln-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 Work to Start: June 17, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: EDWARD M LYNCH License Number: 35609 �/
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: WEST YARMOUTH, MA, 026733818 WEST YARMOUTH MA
026733818 Fee Paid: $250.00
Email: pinchcalllynch@icloud.com Business Telephone: 774-280-8338
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 of Massachusetts Official Use Orgy s -
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Permit No.: `[
_ 7/11 fgt Department of Fire Services Occupancy and Fee Checked:
LL! . '" : t� , W BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/2023]
> N cr ,.. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL ORK
—' I `.. ? All work to be performed in accordance with the Massachusetts Electrical Code(MEC),/5 .0 .
!�� Qi or Town of: YARMOUTH_ Date: s�
U : i t e Inspector of Wires: By this appl'c on, under gne I es notices . is or her intention to perform the elect cal wor describe below.
r' °c ion r&(Street N tuber :
jtJ� / e 6 Unit No.:
Cr . -r or Tenant: f C et/ Email:
is Address: Phone No.:
Is this permit in conjunctipy with a jlding permit?(Check appropriate box)Yes/4 No ❑ Permit No.:
Purpose of Building: wel(( Utility Authorization No.:
Existing Service: Amps / Volts Overhead❑ Underground❑ No. of Meters:
New Service: Amps / Volts verhead❑ derground ❑ No. of Meters:
DRot /O41
iption of Pro sed Electrical Installation: ti0 a tm --- f
R( F 4 r /l� 9 9l' >� '` jf'
Completion ofthefollowinable may bd waived by the Inspector of Wires. `�0 �—�.
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.D Above-Grnd. 0 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❑ No. of Outlets:
No.Energy Storage Systems: KWI-I 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 E Ground-Mount❑ Level I ❑ Level 2 D Level 3 0 Rating:
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Elec i l W rk: (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 ❑ or C-1 ❑ LIC.No.:
Master/Systems Licensee: 1.740�j LIC.No.:
Journeyman Licensee: 564 LIC. No.:7 qe,?r
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC. No.:
Address:
Email: ��G /rG Y 0 C0 _ Telephone No.:77 F- f''7?9
I certify,and he pain n enalties perjury,that the ' f rmation(on tills applicar n is true and complete. 2,� Z(�
Licensee: Print Name: 4 , ZZe fC Cell. No.: 77 � o — p
INSURANCE COVERA E: less waived by the owner,no permit for the perforktance 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 - me to the permit issuing office.
CHECK ONE: INSURANCE BOND 0 OTHER❑ Specify:
OWNER'S INSURANCE I ER: 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.:
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RECEIVED
- -- [ JUN 20 2024
BUILDING DEPARTMENT
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