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Home My WebLink AboutBLDE-23-20013 12/12/23,2:54 PM about:blank . Commonwealth of Massachusetts oF ,y Town of Yarmouth ,z �` $ Os j, ELECTRICAL PERMIT Job Address: 21 LAKE RD Unit: Owner Name: LAUZON RACHAEL N Owner's Address: 21 LAKE RD Phone: Email: Purpose of Building Residential Utility Authorization No.: 15495084 Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-20013 Existing Service Amps L Volts Overhead ❑ Underground El No. of Meters: New Service Amps/Volts Overhead❑ Underground❑ No. of Meters: Description of Proposed Electrical Installation: Replacement exterior service. 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: ,eTotal KK: ti , Space Heating KW: Heating Equipment KW: No. Motors: Total HP: ,.hotel KW: , , .y,. No.Heat Pumps: Total KW: Total Tons: Fire Alarm System 0 No.of Devivsir/O Swimming Pool: ln-Grnd.❑ Above-Grnd.❑ Hot Tub❑ No.of Self-Contained Detection/Alerting Devide _ No.Oil Burners: No.Gas Burners: Video System El No.of Devices: t,' .. J No.Air Conditioners: Total Tons: Telecom System ❑ No.of Outlets: r' -i No.Energy Storage Systems: KWH Storage Rating: Security System ❑ No.of Devices: ✓p 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: $ 1,000 Work to Start: November 18, 2023 FIRM NAME: License Number: Master/System and/or Journeyman Licensee: DAVID E COLEMAN License Number: 17221 Security System Business requires a Division of Occupational Licensure "S" LIC. License Number: Address: MARSTONS MLS, MA, 026481048 MARSTONS MLS MA 026481048 Fee Paid: $50.00 Email: coelect@comcast.net Business Telephone: 508-428-7445 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: about:blank 1/1 Commonwealth of Massachusetts Official Use ly Permit No.: (=.2j 1 /3 At—_ 110:_ru. Department of Fire Services Occupancy and Fee Checked: k' 1-1 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023] w,"r"' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 2.00 City or Town of: Yarmouth Date: /2/1$7 .23 To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the electrical work scribed below. Location(Street&Number): e2 / i a k'� (Zap 4l... id, yx# ,4I. Unit No.: Owner or Tenant: 4,/I lck y 4 tilp:yli Email: Owner's Address: S A.el,.c.., Phone No.: Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No❑Permit No.: Purpose of Building: R4 Site-4-4 ' Util' Authorization No.: /SY 1 „4 05'/ Existing Service: /OO Amps /7O/ 20C Volts Overhead derground❑ No.of Meters: / New Service: /00 Amps 420 /?YO Volts Overhead(QUnderground❑ No.of Meters: / Description of Proposed Electrical Installation: /,/ 4-d+-4.1(c,- c.v.,. f`q.o,st /4.4,4.) re Po et1 ,F C't „e .-i AY,eta So o it.4%. �r v.t-1 F x ll s T-,.N. ee Sv, .e. P,�� / 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: R E C F I V F D 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: D�r 2023 Swimming Pool:In-Gmd.0 Above-Grnd.0 Hot-Tub 0 No.of Self-Contained Detection/Alerting Devi:es: l► No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices: __ __ _ No.Air Conditioners: Total Tons: Telecom System 0 No.of Outlets: BU i t UI NCi U1 PA l2TM E NT ay. 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 Equipment: No.of Modules: Roof-Mount 0 Ground-Mount 0 Level 1 0 Level 2 0 Level 3 0 Rating: OTHER: _ i A/1 t►. 6 it 3 pry,;��;,t RCA....r.-r- D 0+-- I ei Di 1�. ✓ as J k)1✓✓;.- I tAkA y Attach additional detail if desired,or as equired by the Inspector of Wires. 5/� L4asl Estimated Value of Electrical Work: 9 d" (When required by municipal policy) Date Work to Start: // /1 2 Inspections to be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: Colema Elec ic Inc A-1 Ej or C-1 0 LIC.No.: Master/Systems Licensee: LIC.No.: A17221 Journeyman Licensee: LIC.No.: E29607 Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: Address: 62 Fleetwood Path,Marstons Mills Ma 02648 Email: Coelect@comcast.net Telephone No.: 508-428-7445 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. Licensee: David Coleman Print Name: An _ i/e-dehtadf, Cell.No.: 508-364-8456 INSURANCE COVERAGE:Unless 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 0 OTHER❑ Specify: /„a i' e I. ;.)) OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insrurance coverage normally required by law.By my signature below,I hereby waive this requirement.I am the:(Check one)Owner❑ Owner's agent 0 Owner/Agent: Tel.No.: Signature: Email.: