HomeMy WebLinkAboutBLDE-23-19981 EXPIRED 12/8/23,5:03AM about:blank
Commonwealth of Massachusetts of • Yam,
*� Town of Yarmouth , c
ELECTRICAL PERMIT !cov`� ::,r
Job Address: 41 BRAY FARM RD SOUTH Unit:
Owner Name: SAFARIK WALLACE JOHN SAFARIK LYNN
Owner's Address: 30 ST CLAIR DR Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19981
Existing Service Amps/Volts Overhead Cl Underground ❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Boiler Replace
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:
Space Heating KW: Heating Equipment KW: No. Motors: Total HP: �ATgtal KW:
No. Heat Pumps: Total KW: Total Tons: Fire Alarm System Cl No.of Devices:
Swimming Pool: In-Grnd.❑ Above-Grnd.❑ Hot Tub❑ No.of Self-Contained Detection/Alerting Devices:
No. Oil Burners: No. Gas Burners: 1 Video System ❑ No.of Devices: ,,.7?
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 El Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 500 Work to Start: December 11, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: MATTHEW KANE License Number: 55328
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: SOUTH YARMOUTH, MA, 02664 SOUTH YARMOUTH MA 02664 Fee Paid: $50.00
Email: mariah@seasidegasservice.com Business Telephone: 508-771-2768
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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