HomeMy WebLinkAboutBLDE-23-19052 7/6P3,6.Q AM V11
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Commonwealth of Massachusetts -off:y ,A
IV Town of Yarmouth • $ �•
ELECTRICAL PERMIT ;�'�
Job Address: 27 &29 MILL POND RD Unit:
Owner Name: SIVITSKI ANATOLI BARODKA KATSIARYNA
Owner's Address: 27 &29 MILL POND RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19052
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
Description of Proposed Electrical Installation: Re-wiring the basement and install a sub panel. Replace the 2 existing main
panels with 2 new main panels.
No.of Receptacle Outlets: 15 No.of Switches: 10 Generator KW Rating: Type: Cf
No. Luminaires: 5 No.of Recessed Luminaires: 14 No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA: /
Space Heating KW: 1 Heating Equipment KW: No. Motors: Total HP: Total KW:
No. Heat Pumps: Total KW: Total Tons: Fire Alarm System ElNo.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: $ 6,500 Work to Start: 7 f c (Z3
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: IVAN GARUTA License Number: 58823
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: CENTERVILLE, MA, 02632 CENTERVILLE MA 02632 Fee Paid: $75.00
Email: support@lainner.com Business Telephone: 508.827.1514
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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o TOWN OF YARMOUTH
'o ii n•iy,SC c HEAlt,TH DEPARTMENT
PERMIT APPLICATION SIGN OFF Tlt l\iSMI TA.l SHEET
To be completed by Applic J 1
e r
Building Site Location: 2 2-5 Ai I( f AN3 14 LA t\eois' p No.: Lot No.:
Proposed Improvement: W G1 L I ! r" , • , �� a,- p-cpo u
N,�'2v C. per\ Le c.Q G.or" y {r00f� t T137V .}( 'dire.". % r) {-. G. S erg 9na't . -
Applicant: ri (Act-4 �L, V. S' v ,1 S k.t,; - , U I l Tel, rio.:(6' ) 7 /0 I ci o I
•Address: 27- M `QQ P--r`al A ) -e A- a�G "
r '415 LLi
Date Filed' Z�,O I I '3 ( OO
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**Ifyou would like e-mail notification of sign off is provide e-mail address: ')
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Owner Name: l ���G� o - I ti u
Owner Address: 2..3 MA.. P' ` V c( i! ) . (6. Owner Tel No.:(6 4) 1�(Cr3(
RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements ' J
For Septage Disposal and other Public Health Activities. i`.
Please submit four (4) copies of plans, to include:
(1.) Site Plan showing existing buildings, water line location,
and septic system location;
(2.) Floor plan labeling ALL rooms within building
(all existing and proposed)—
Note: F(oT plans not required for decks, sheds, windows, roofing;
. '(3 )i. If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: DATE: dI�/O Cr
• PLEASE NOTE
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