HomeMy WebLinkAboutBLDE-24-1292 8/20/24,3:50 PM about:blank
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,, Commonwealth of Massachusetts OI YAK
* Town of Yarmouth '� [
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ELECTRICAL PERMIT ����o" ",....-,
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Job Address: 30 DESERT SANDS LN Unit: fo -73 7- t754
Owner Name: COUGHLAN GERALD D TRS
Owner's Address: P 0 BOX 517 Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-24-1292
Existing Service Amps/Volts Overhead El Underground ❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground El No. of Meters:
Description of Proposed Electrical Installation: Replacement boiler
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: 1 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 El Level 1 ❑ Level 2 0 Level 3 El Rating:
Estimated Value of Electrical Work: $ 100 Work to Start: June 14, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: JESSE R LING License Number: 15646
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: WEST CHATHAM, MA, 026691200 WEST CHATHAM MA
026691200 Fee Paid: $200.00
Email: rewire@comcast.net Business Telephone: 508-400-2233
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:
Cai 8(?—?ki( a--
RECEIVED
AUG 2 0 2024
BUILDING DEPARTMENT
By -------___
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APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK
All work ro Se performed*:acoor Zce cv ^e?v�assz:O-• �;ep.. Code
� sans_..,,,�� () -^_l, C?�iR x
(PLEASE Pt�?v 1- 1 ii OR 1: _E,-1 T .: 0�. ,L1 r0�v 6h L{
MOUTH J Date: cto !
City or Town of: •
application�_, - V - L c :rze i?zsv=c:or of Wires:
By this adersifie_ =ves notice of his o- e-intention:o rfoeiec
:_ :�the_ t-ical work described below.
Location (Street J Number)_ 0 bto SC4.21 5 ery.ko 5 1--.A-
Owner or Tenant 6 . G U C1(.a Ei lA--k Telephone No.
Owner's Address S. ('-
Is this permit in ccnJunction with a buiding Yes : N
permit? o X. (Ch..cl.Appropriate Box
Purpose of BuildiFg 7 Lw e L�r N Al .4
T C�- �•An�orzation No.
Existing Service 1('CU Amos Voles Overhead V\ Unclgr.d _ No. of Meters
New Service (�I
Amps Volts Overhead Undgrd i i No. of Meters
Number of Feeders and Ampacity ,C` . ( r`
Location and Nature of Proposed Elect-icaI Work: ed
3 C c tE 0- 0-42tiltt-c.w 64c sk'T
I
Ca—ale—'—ion of the joLOw o tale rr� be waives• he fr
No. of Recessed Lt:rninaii es sD�aOr of
L,o.of Cexl m
.-Soso.(Paddle)Fans !Transforers Total
mo .of LIIair.2ire OIIe i
tin.of lint Tubs !Generators KVA
No.O ninaires !''wrrr rnrcg Pool Abodve ln- �_ , o_ =ter.- - . 1,, i¢�ug
=rnd. (BNattea rs II ..
No.of Receptacles- >rs 'a.of Ott Burners I
s: - ALARMS 1Na.of Zones
No.of Switch es ®a•.of Gas Burners 'o.of Detection and
w
Initiating Devices
!No.of Ranges , o. of Air . - To - Z.
,s INo.of Alerting Devices
!No.of Waste Disposers =seat Pump !Number KW INo.of Self-Contained
i Totals: I IDe on!_4Iertiag Devices V],
!No.of Dishwashers j�paceArea - sting KW '�faaicipal `�
Connection L Otter
No. of Dryers ;.�eati• Appliances !Seca - •sterns::
INo.of Water
I Heaters ICW
'{� No.of ices or Equivalent
•. of No. of Data; Wiring,:
Signs Ballasts No.of Devices or EquivaIent
i o. Hydromassage Bathtubs "o. of Motors Total ITP T=leco taro anicatioas VF'Inn;:
;OTHER:
No.of Devices or E•uivalent
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-
Estimated Value of Electrical ov .ttacr.addi'?ory/de_+cil-desired or . - •p 1!o , c .
"I
S �tr ca1 Ott l�O (W ea readred by m'2n cai poll _
i: r~ )
Work to Start:_ ._
Inspections to be requested in accordance with MEC Rul 10 as er p �,
INSURANCE COVE .
COVERAGE: Jaless waivedbyL �c owner,no pe.�.t for the performance b,e :.ctrical work may issue� ,I the}ICensee provides proof of liability insurance including"completed ooerauo'"coverage r
t nde fined ceralies that such coverage is;.a � E` tE e
force, and has ext oiled proof of same to the p '- :.:e.
CHECK ONE: :NSURANCE X BOND I -_—
O : R ;;t (Speci -) _
I cerify, under the pairs and penalties of perjury, that the information on this application Lstrue and complete. 0✓213 3
FIRM NAME: L "Co L L-&c. Q
�0-t•-o iGr-9.-t LIC.NO.: l ��p.t6
Licensee: 3-• i..Z- L. f:1,(0
(Ifapplicable,,z nt "exempt" : Signature -� dC „ j LIC.o.: 6
1�e er p :r,the license^limber li-e
Address )- ^LZ� .GN�Zfi 1-' O��06� Bus.TeL No.: 6 - -re 77L{
t `Per M.G.L.c. 147, Alt.Tel.No.: a -a 2s�o y,
s.b i-o i,security work requires Department of?ub1:c Safety"S"License: Lic.No.
— OWNER'S INSURANCE WAIVER: I em 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) y
Owner/Agent owner ❑owner's agent.
Signature Telephone No. , PERMIT FEE: $ 1