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HomeMy WebLinkAboutBLDE-23-19117 7/18/23,3:07 PM about:blank - , L r Commonwealth of Massachusetts ov • yA, *. � Town of Yarmouth 3.�• 0 t ELECTRICAL PERMIT ° . Job Address: 154 MAYFLOWER TERR Unit: Owner Name: MAJEWSKI MICHAEL Owner's Address: 154 MAYFLOWER TERR Phone: Email: Purpose of Building Residential Utility Authorization No.: Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19117 Existing Service Amps/Volts Overhead 0 Underground 0 No. of Meters: New Service Amps/Volts Overhead 0 Underground 0 No. of Meters: Description of Proposed Electrical Installation: Replacement water heater. 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: 1 KW: No.Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No.Motors: Total HP: . tal KR ` , No.Heat Pumps: Total KW: Total Tons: Fire Alarm System 0 No.of Devicesr " Swimming Pool: ln-Grnd.0 Above-Grnd.0 Hot Tub 0 No.of Self-Contained Detection/Alerting DeviCg:. No.Oil Burners: No.Gas Burners: Video System El No.of Devices: No.Air Conditioners: Total Tons: Telecom System 0 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 0 Level 2 0 Level 3❑ Rating: Estimated Value of Electrical Work: $ 1 Work to Start: July 14, 2023 FIRM NAME: License Number: Master/System and/or Journeyman Licensee: TODD A HIGGINS License Number: 13438 Security System Business requires a Division of Occupational Licensure "S" LIC. License Number: Address: ORLEANS, MA, 026531958 ORLEANS MA 026531958 Fee Paid: $50.00 Email: Ralph@3gsplumbing.net Business Telephone: 508-237-6295 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 ._ lR I / F FJUL 18 2023 . '/ �/ /� � �� Official Use Only Commonwealth.o///IaJaCIfWBLfa 22 ' c { L.DI dC UEr ARTMt i`dcntitN0. C-�3 -- 1 . 'l ,•1r'h ri l a a,tm ni o�c7 ' I' =-ri.. P I }irrr = _ _.d •• ►i- ,+ Occupancy and Fee Checked 1-.,'" BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK j All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CM12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7- PO City or Town of: YARMOUTH To the Inspector of Wires: day this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) l S y y✓I' y-F e,c)c / L'2 2,e4 C-C_--: Owner or Tenant 01/C i'/4-L`Z 44A,C c= 1✓..5 j Telephone NoS »� %7. _F--' Owner's Address / -5 ►7L 4,-rl,12( 1—F . d kt)v "7'C_l?A,4 CC -5c'is � Are-,.-Pl o✓7 Is this permit in conjunction with a building permit? Yes ❑ No ® (Check AppropriateGG Box) Da CC,/ Purpose of Building 'Lrsl'pL^Y G Utility Authorization No. i Existing Service Amp! / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity i Location and Nature of Proposed Electrical Work: in.) l iZ--L ,i t2 c4 ( ' ' �:�/1 7" LZ_e_ c-772/C_ u>,,c7 ^C? /—( -= :-1� - t Completion of the followin table nig be waived by the Inspector of Wires. va otal ll r.jf No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans Transformers KVA (t No.of Luminaire Outlets No.of Hot Tubs Generators KVA r�A t No.of Luminaires • SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting grad. grnd. Battery Units No.of Receptacle Outlets No.of OH Burners FIRE ALARMS No.of Zones • No.of Switches No.of Gas Burners No.of Detection and v. Initiating Devices II' No.of Ranges No.of\Air Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number.. Tons KW No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water , No.of No.ofK Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP 'Feleco ofDeviat ons r g No. Device i,or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires, Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 7 /yr 2,3 Inspections to be requested in accordance with MEC 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 Q BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjurv,that_the information on this application is true and complete. FIRM NAME: '�09, r/76. � L=CZ?GTrZ-/�" LIC.NO.:,/) /3 6/0 Cr Licensee 2 4 . /7)6 Aso?/ Signature?�.�A // LIC.NO./J ;1-�(--(cr—•-- (Ifapplicable,enter" mpt"in the lice nu cline.) l Bus.Tel.No.•3`e)��.37G�p_�— Address: 2©• '2 - 7 O2C_C.' 701,9 02`C.,5 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lac.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 Signature Telephone No. PERMIT FEE: $ g4c,P1--1C) 3 3s pz, vvvatA.c . �f" . 1