HomeMy WebLinkAboutBLDE-23-19484 !/13/23,7:49 AM about:blank
Commonwealth of Massachusetts oF • YA�,,
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u Town of Yarmouth, �,tc�
ELECTRICAL PERMIT •
Job Address: 81 WINSLOW GRAY RD Unit:
Owner Name: TAVES JOEL
Owner's Address: P 0 BOX 234 Phone: Email:
Purpose of
Building Residential Utility Authorization No.: 1
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19484
Existing Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
New Service Amps 200/Volts Overhead M Underground 0 No. of Meters: 1
Description of Proposed Electrical Installation: New residence
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: , [d
No.Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of 14vtces: /
r
Swimming Pool: In-Gmd.❑ Above-Gmd.❑ Hot Tub❑ No.of Self-Contained Detection/Alertin9 Devices: .i
No.Oil Burners: No.Gas Burners: Video System ❑ No.of Devices:
No.Air Conditioners: Total Tons: Telecom System ❑ No.of Outlets: ;i
No.Energy Storage Systems: KWH Storage Rating: Security System ❑ No.of Devices: v
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 0 Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: September 13, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: MICHAEL YOUNG License Number: 22314
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: W BARNSTABLE, MA, 026681350 W BARNSTABLE MA
026681350 Fee Paid: $180.00
Email: mpyoung156@comcast.net Business Telephone: 774-994-2406
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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Official
Commonwealth of Massachusetts Permit No.: t:2-3Use nA i.4 Qj.1
1_=tip—r Department of Fire Services Occupancy and Fee Checked:
to=- BOARD OF FIRE 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 MR .00
City or Town of: YARMOUTH Date: �y /a:,,3
To the Inspector of Wires:By this"ylication,the undersigned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): ,,'/ /t/in/S w 6 k'sdG/,2 ) Unit No.:
d/% I/
Owner or Tenant: f Z �� � v// Email:
Owner's Address: O /3n 3 4��itU��N p?/11]. Phone No.: 77 r' 5:7y a S/D(P
Is this permit in conjunction with a building permit?(Check appropriate box)Yes ' o 0 Permit No.:
Purpose of Building: Utility Authorization No.:
Existing Service: /cc c Amps /24/d/U Volts Overhead[�fl��derground 0 No.of Meters: /
New Service: _ ,dei a Amps/„7ti dye, Volts Overhead Underground❑ No.of Meters:
. Description of Proposed Electrical Installation: 414,/,rfQ poor /✓y 1 `j",S e
Py/`/ st_ /Pa r CJZ-
Completion of the following table may be waived by the Inspector of Wires.
No.of Acceptable 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-Grad.0 Above-Gmd.❑ 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❑ 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 I❑ Level 2 0 Level 3❑ Rating:
OTHER:
Attach additional detail if desired,ores required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy)
Date Work to Start: / Inspections j,be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: y0✓.J 6- Ic0 //GaZ- �N( —101 e- A-1 0 or C-1❑LIC.No.:
Master/Systems!Licensee: /2i//ice,/ya-�L �tiwt LIC.No.: �a 3/, 4
4Journeyman Licensee: P N it-et ] fir-,,-(ram LIC.No.: 37 9 9 9 G
Security System Business r u�ires a Division of Occupational Licensure"S"LIC.C. S-LIC./No.:
Address: /SZZ Lnl 5 77.ai L Aie5% I'JYK�S�I3 /Y4-
Email: rn�yd v 4-/� e LifA5%%• "he I' ' Telephone No.: 77y— 7 z yp•cf2
I certlft,under the pains and penalties of perjury,that the information on this application is true and complete.
. Licensee: Print Name: Cell.No.:
INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance 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 of same to the permit issuing office.
CHECK ONE: INSURANCE 0 BOND 0 OTHER❑ Specify:
OWNER'S INSURANCE WAIVER:I am aware that the Licensee does not have the I. -' I+ r ally
required by law.By my signature below,I hereby waive this requirement.I am the:(Chec.oa Evaar! 1.••B .,- t 0
Owner/Agent: Tel.No.:
Signature: Email.: ■ SEP 12 202 Al
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B��D [)EPARTMENT
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