HomeMy WebLinkAboutBLDE-24-1798 W 1 l/>°ni a;/ I /iicIL 11C-e___
Commonwealth of Massachusetts Ofl•;�;l�uie O�y7q s
Permit No.: Ci Uri
Department of Fire Services Occupancy and Fee Checked:
-Mal V II
l -e 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 CMR 12.00
City or Town of: YARMOUTH Date: 11/14/24
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): 111 Evergreen St Unit No.:
Owner or Tenant: Paul Swartzwelder Email: swartzy51@comcast.net
Owner's Address: 111 Evergreen St Yarmouth,MA Phone No.: 508-951 -0711
Is this permit in conjunction with a building permit?(Check appropriate box)Yes El Non Permit No.:
Purpose of Building: residential Utility Authorization No.: /93 ZSS 9 B
Existing Service: 100 Amps 240 /120 Volts Overhead% Underground El No.of Meters: 1
New Service: 100 Amps 240 /120 Volts Overhead• Underground❑ No.of Meters: 1
Description of Proposed Electrical Installation: replace electrical service due to failure, properly bond and ground system.
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 0 No.of Devices:
Swimming Pool:In-Grnd.❑ Above-Gmd.❑ 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 El No.of Outlets:
No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipri :nECEIVED
No.of Modules: Roof-Mount 0 Ground-Mount❑ Level 1 0 Level 2❑ Level 3❑ Rating----- -------
OTHER:
_ NOV 15. 2024___..
Attach additional detail if desired,or as required by the Inspector of Wires. _
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Estimated Value of Electrical Work: (When required by ipRiV6lip3JPARTMENT
Date Work to Start: 11/14/24 Inspections to be requested in accordance with MEC Rule 10,111a upon completion.
FIRM NAME: Egan Electric Corp A-1 ❑■ or C-1 0 LIC.No.: 2148
Master/Systems Licensee: James egan . LIC.No.: 20668A
Journeyman Licensee: James egan LIC.No.: 51687E
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: 9095 Rt 28 South Yarmouth,MA 02664
Email: Jim@eganelectriccorp.com Telephone No.: 508 380 1084
I certify,under pains and penalties of perjury,that the information on this application is true and complete.
Licensee: /! Print Name: James egan Cell.No.: 508 380 1084
INSURANC OVERAGE: nless 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❑■ BOND El OTHER❑ Specify:
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 El Owner's agent El
Owner/Agent: Tel.No.:
Signature: Email.: