HomeMy WebLinkAboutBLDE-23-19506 9/18/23,5:48 AM about:blank
Commonwealth of Massachusetts ol 'Y14>
Town of Yarmouth S ik C
s' y.
ELECTRICAL PERMIT \\k\,
{
Job Address: 3 JERUSHA LN Unit:
Owner Name: LAREAU JEFFREY M LAREAU KIMBERLY A
Owner's Address: 69 FRANCIS ST Phone: Email:
Purpose of
Building Residential Utility Authorization No.: . "
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19506
Existing Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
New Service Amps I Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Grounding, bonding, &wiring for new pool.
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 Work to Start: September 18, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: EDWARD L MERRY License Number: 17137
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: W YARMOUTH, MA, 026733636 W YARMOUTH MA 026733636 Fee Paid: $185.00 CA tiki'sP
Email: edwardmerryK@gmail.com Business Telephone: 508-221-4335
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:
ttS=1%,n,0 t c aP- (—�Ae(C, t Ct(l a(23 K _,
'T14-1\-01 .ry-04 41.50-sE (01 ,412- -L.)
VA-1 \C Ci-C-2-0 Notmc, Cam (., ) LC(1,1,23 t m -.UMpC-e
k, R-Lkc-, Cal- -11-.)- cA,t u k_v(klm
t4esc -I-2.c,c- t_
tNiz; 't.reve-,-(_ ,...C-I D L(k 312)4 Ci2e.,,)mi) te- kt"..4f-'
C -LtA))
Exii.: ....„
\��
1/1
about:blank
• CMnmonwealth ol 7140.4aclut.441.4Official Use Only
-= = // 3ire
Permit o. C104
— _ Theparbneni o Serviced
'1 1= �z' Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/0 (leave blan )k
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (NEC), 527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9/13/2023
City or Town of: Yarmouth To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number) 3 Jerusha Ln
Owner or Tenant Jeff Lareau Telephone No. 508-221-4335
Owner's Address same
Is this permit in conjunction with a building permit? Yes 12 No 11 (Check Appropriate Box)
Purpose of Building residence Utility Authorization No.
Existing Service Amps / Volts Overhead 111 Undgrd III No. of Meters
New Service Amps / Volts Overhead 111 Undgrd II No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: pool wiring/bonding
Completion of the following table may be waived by the Inspector of Wires.
No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of 1
Transformers KVA
No. of Luminaire Outlets No. of Hot Tubs Generators K VA
No. of Luminaires Swimming Pool Above ❑ In- ❑ No. of Emergency Lighting
grnd. grnd. Battery Units
L, No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones
cJ No. of Switches No. of Gas Burners No. of Detection and
Initiating Devices
N\ No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices
No. of Waste Disposers Heat Pump Number Tons KW o. of Self-Contained
P� Totals: _ Detection/Alerting Devices
,°� Mu
No. of Dishwashers Space/Area Heating KW Local ❑ Connecnicitpioaln ❑ Other
No. of Dryers Heating Appliances KW Security Systems:*
No. of Devices or Equivalent
i No. of Water No. of No. of Data Wiring:
ICVV
44.1 Heaters Signs Ballasts No. of Devices or Equivalent
5 No. H d massy Bathtubs No. of Motors Total HP Telecommunications Waring:
yr° ge No. of Devices or Equivalent
i J OTHER:
Attach additional detail if desire4 or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: 9/13/2023 Inspections to be requested in accordance with MEC Rule 10, and upon completion.
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.
CHECK ONE: INSURANCE El BOND ❑ OTHER ❑ (Specify:)
I certify, under the pains and penalties of perjury, that the information on this application is true and complete.
FIRM NAME: Ed Merry Master Electrician, Inc LIC. NO.: 17137A
Licensee: Ed Merry Signature store LIC. NO.: 35745E
(If applicable, enter "exempt" in the license number line.) Bus. TeL No.;5° '2214335
Address: 15 Checkerbeny In Wesy Yarmouth, Ma 02673 Alt. TeL No.:
*Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No.
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) El owner [] owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE: $