HomeMy WebLinkAboutBLDE-23-18880 6/13/23,6:18 AM \15\ about:blank
Commonwealth of Massachusetts -�og • v�"�
Town of Yarmouth0,
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ELECTRICAL PERMIT rvx
Job Address: 311 GREAT ISLAND RD Unit:
Owner Name: LIPNICK SCOTT
Owner's Address: 108 CHANDLER ST Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-18880
Existing Service Amps/Volts Overhead ❑ Underground ❑ No.of Meters:
New Service Amps/Volts Overhead Cl Underground ❑ No.of Meters:
Description of Proposed Electrical Installation: Replace 1st floor sub panel, add exterior sconce & receptacle.
No.of Receptacle Outlets: 1 No.of Switches: Generator KW Rating: Type:
—
No.Luminaires: 1 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: ln-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: $2,500 Work to Start: June 6, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: JOHN MARA License Number: 58035
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: WEST YARMOUTH, MA, 02673 WEST YARMOUTH MA 02673 Fee Paid: $75.00
Email: mara.john.r@gmail.com Business Telephone: 310-613-2225
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:
( 0,L)c.44 1(it-r( 5 (PAiva 66- 4//2_ PA-uxe. .6,0110
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023 ommonwealth of Massachusetts Official Wye $
t ____ Permit No.:
—_ 1�i=, Department of Fire Services Occupancy and Fee Checked:
Bu,,:,,- I;1.`s> ',BOARDl OF FIRE PREVENTION REGULATIONS (Rev. 1/2023]
BY
Y"�=' 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:
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): 3 I I G e g h}j I S L AN 0 V Unit No.:
Owner or Tenant: Sc.o-r r L t p N .c . Email:
Owner's Address: 311 GG £E 4 T 1 S LP. 1N 0 F.17 Phone No.: 3 1 v — 6 /3 - .2..1.,2 s
Is this permit in conjunction with a building permit?(Check appropriate box)Yes 0 No❑ Permit No.:
Purpose of Building: RES t at tJ T/4 1. Utility Authorization No.:
Existing Service: .2 6 6 Amps2 yU / !2 o Volts Overhead ErUnderground❑ No. of Meters: /
New Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:
Description of Proposed Electrical Installation: 4-,PL/4-L / 57- FLOO/L Sct8 ?RN L L I
A-DD EX7762l a 2 S coN c E -I- la Ec EPrip9-c. L S'
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-Gmd.0 Above-Gmd.❑ Hot-Tub 0 No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System 0 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 0 Level 1 ❑ Level 2 0 Level 3 0 Rating:
OTHER:
Attach additional detail if desired,or as r uired by the Inspector of Wires.
Estimated Value of Electr' al W rk: / .2,3'O d (When required by municipal policy)
Date Work to Start: 6/6 .23 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: T,I/I) Mft,231 A-1 ❑ or C-1 ❑LIC.No.:
Master/Systems Licensee: LIC.No.:
Journeyman Licensee: rg O 3 5-- .3 LIC.No.:
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: / 5— ?i Al 6fr...s 6 Oaf) A D LA) . YA-12-1,k o ..'T t4
Email: Mhit 4. :mJe imi. )a- be q M J t L . ( o 0,1 Telephone No.: 33 7 �.� --.4 1- 4,
I certify,under a pains andenalties of perjury,that the information on this application is true and complete.
Licensee: rsPrint Name: 1-6 tl-u R. , $1 A.R 4 Cell.No.: 3 3 1-9,23" 9s-ot(7
INSURA OVERAGE: ess waived by the owner,no permit for the performance of electrical work may issue unless the licensee
provides proof of liability including"corn ted operation"coverage or its substantial equivalent.The undersigned certifies that such coverage
is in force and has exhibited proof of s e to the permit issuing office.
CHECK ONE: INSURANCE BOND❑ 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❑ Owner's agent❑
Owner/Agent: Tel.No.:
Signature: Email.: