HomeMy WebLinkAboutBLDE-23-19048 permit expired 10/29/247/3/23, 2:07 PM about:blank
Commonwealth of Massachusetts
Town of Yarmouth
ELECTRICAL PERMIT
Job Address: In t1v r t` d:p: Gr_ Unit:
Owner Name: OA V t D �=-C cu t
Owner's Address: Phone: Email:
Purpose of
Building Residential
Is this permit in conjunction with a building permit? No
Existing Service Amps / Volts Overhead ❑
New Service Amps / Volts Overhead ❑
Description of Proposed Electrical Installation: Mini split system
Utility Authorization No.:
Permit Number: BLDE-23-19048
Underground ❑ No. of Meters:
Underground ❑ No. of Meters:
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. Tran o ,ifs: Total KVA:
Space Heating KW:
Heating Equipment KW:
No. Motors: '" Total HP: Total KW:
No. Heat Pumps: Total KW: Total Tons:
Fire Alarm SysteiWEXV No. of Devices:
Swimming Pool: In-Grnd. ❑
Above-Grnd. ❑ Hot Tub ❑
No. of Self -Contained etection/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 Modules: Roof -Mount ❑ Ground -Mount ❑
No. of Electric Vehicle Supply Equipment:
Level 1 ❑ Level 2 ❑ Level 3 ❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: July3, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: JOSEPH W SILVA License Number: 9147
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: SANDWICH, MA, 025632761 SANDWICH MA 025632761 Fee Paid: $50.00
Email: silvaelectric52@gmail.com Business Telephone: 508-428-9081
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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l ommonwealth o�ec///I/a�ac�iu�eii� �Official Use Only
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o[IeIlarJsmento�,lire�eruccas Permit No.
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLEASE PRINT MINK OR TYPE ALL INFORMATION) Date: (-d-3
City or Town of �(4 -1440T l-1 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) C� F V u2y IZ� �►�1 S"
Owner or Tenant -12is v i D EU d C L— Telephone No.
Owner's Address <-d I f -
Is this permit in conjunction with a building permit? Yes ❑ No ED--- (Check Appropriate Box)
Purpose of Building RS S i D4.,J'1 At— Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: k_A; ; (C� 0 1 Nt Sil l r S
Completion ofthe followinz table may be waived by the Inspector of Wires.
No. of Recessed Luminaires
No. of Ceil.-Susp. (Paddle) Fans
No. of Total
Transformers KVA
No. ofLuminaire Outlets
No. of Hot Tubs
Generators KVA
No. of Luminaires
Above o In-
Swimming Pool rnd. grnd.
No. of Emergency Lighting
Batte Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Initiating Devices
No. of Ranges
Total
No. of Air Cond. Tons
No. of Alerting Devices
No. of Waste Disposers
P
Heat Pump
Totals:
Number
Tons
No. of Self -Contained
Detection/Alerting Devices
_
No. of Dishwashers
S ace/Area Heating KW
p g
Municipal El Other
Local ❑ Connection
of Dryers
Heating Appliances KW
SystNo.
SecuriNo. f Devices or E uivalent
o. of Water KW
Heaters
No. of No. of
Signs Ballasts
Data Wiring:
I No. of Devices or Equivalent
No. a Bathtubs H dromassa
y g
No. of Motors Total HP
Telecommunications Wir'-o:
No. of Devices or E uivalent
OTHER:
Altacn aaattional aetatt J aestrea, or as requtrea ay the Inspector of wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: �,""LZ- Z3 Inspections to be requested in accordance with NIEC 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 (BOND ❑ OTHER ❑ (Specify:) -,� �S
X certify, under the pains and penalties of perjury, that the information on this application is true and compte7e.
FIRM NAME: .S [L-V q >✓ 4YL tZl LIC. NO.:A
Licensee: _-� aSyF'h t—1 S t,e- ✓A- Signatur�41-,
LIC. NO.: Z�G {y
(Ifapplicable, enter "exempt" in the license number line. Bus. Tel. No.• �� �Z `��' FAddress:3-9 00cV2 - 0�-r'j %� �.Q'9r`G-6 --S Alt. Tel. No.•
*Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lie. 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) ❑ owner ❑ owner's agent.
Owner/Agent PERMIT FEE: $
Signature Telephone No.