HomeMy WebLinkAboutBLDE-23-19392 25f' 7:33 AM about:blank
. \, Commonwealth of Massachusetts �oF YAK..
loilrg) Town of Yarmouth
0
ELECTRICAL PERMIT
Job Address: 213 OLD MAIN ST Unit:
Owner Name: SULLIVAN DONALD J SULLIVAN JUDITH M
Owner's Address: 213 OLD MAIN ST Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19392
Existing Service Amps/Volts Overhead 0 Underground❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Wiring for addition &service upgrade.
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: fiti
Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW: 2z
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 CINo.of Devices: 'r-</
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:
Estimated Value of Electrical Work: $ 1 Work to Start: August 24, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: ROBERT M SCENA License Number: 21570
Security System Business requires a Division of Occupational Licensure
"S" LIC. Licen Number:
Address: bourne, MA, 02532 bourne MA 02532 Fee P id: $125.00
Email: bobscena@yahoo.com . Busine h • 8-847-4587
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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/57 PA WI Hy 24t) AM AWL. 134-n4, N- rc t, dLD 44155/4)6 legrt'PrAcG" I'.) 144-t L fl c,,l.,.)
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about:blank 1/1
Commonwealth of Massachusetts Official Use o
t ; C PermitNo.: �"7:3- i`'1 v
7*—; Department of Fire Services Occupancy and Fee Checked:
i-_•I{ 5'' BOARD OF FIRE PREVENTION REGULATIONS [Rev.I/2023]
' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
City or Town of: YARMOUTH Date: 522zc//z"5
To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): c.-/ - ( id y✓/ci,,t s") ' Unit No.:
Owner or Tenant: pi, 5 t, //, i/a✓J Email:
Owner's Address: Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No❑Permit No.:
Purpose of Building: /e 5/G/PAGG Utility Authorization No.:
Existing Service: /gyp Amps/ZO/a56'Volts Overhead Er Underground❑ No.of Meters:
New Service: ZC90 Amps/ZO/L40Volts Overhead 0 Underground El!' No.of Meters:
Description of Proposed Electrical Installation: va -I r•C Y1 C w' &-cl Gd t>1/e'7 et-F7C1-•
vpyrG ef& .SPrc ice
Completion of the following table may be waived by the Inspector of Wires.
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.❑ Above-Grnd.❑ 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 Out etR E C E I V E D
No.Energy Storage Systems: KWH Storage Rating: Security System❑ No.of Del i 999���--,,,,.r,,,��y
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment: Sr.�
No.of Modules: Roof-Mount El Ground-MountEl Level I 0 Level 2 El Level 3 0 P.inn G 2 2023
OTHER:
------ -- BUILDING DEPARTMENT
Attach additional detail if desired,or as required by the Inspector of Wires. -Ely..
Estimated Value of Electrical Work: (When required by municipal policy)
Date Work to Start JZ e /2_3 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: (i(',"7 m l ,VPyt� ,tn,2 4! l..'aCCA-1❑or C-1❑LIC.No.:r'Z./j' 0
Master/Systems Licensee:WC, /7" CCeP74L. LIC.No.:/9`Z- /7 7Cj
Journeyman Licensee: ,f to 4•e.-+- }C-4'.14 LIC.No.: 4 4'oo Ve /
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: �j
Address: ?, � JuiT7o)C' J�
7 'cc c s e l---70, o e. lt'fj/
Email: /36' ,S C Ps-7 e_ /' haooCe7 2 Telephone No.: 5-0.V-S'4'7 c/,3'F'7
I certify,under the pains mid penalties of perjury,that the l nn rmation on this application is true and complete.
Licensee: / '%
7 Print Name:,/C r 7'.' SC P✓74-- Cell.No.: y17Q'' /7-W 5'7
INS �RAGEt Tess 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 a permit issuing office. �'�ii CHECK ONE: INSURANCE OND OTHER 0 Specify: 'e Ao 6-h tr /rj S[iv a
OWNER'S INSURANCE WA VER: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 0 Owner's agent 0
Owner/Agent:
Tel.No.:
Signature:
Email.: