HomeMy WebLinkAboutBLDE-24-937 6/12/24,2:51 PM about:blank
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*� i Town of Yarmouth �,' � 0'�
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ELECTRICAL PERMIT ;`_�`.°4'PoR leo' r ��f
Job Address: 11 BAYRIDGE DR Unit:
Owner Name: BLANCH ELIZABETH M
Owner's Address: 11 BAYRIDGE DR Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-24-937
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead 0 Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Basement remodel with bathroom &mini split system.
No.of Receptacle Outlets: 24 No.of Switches: 12 Generator KW Rating: Type:
No. Luminaires: 8 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: 1 Total KW: Total Tons: 3.4 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 0 Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 7,100 Work to Start: June 11, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: KURTIS LORDEN License Number: 59401
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: HARWICH, MA, 02645 HARWICH MA 02645 Fee Paid: $75.00
Email: kurtlorden@gmail.com Business Telephone: 508-225-1630
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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Commonwealth of Massachusetts Official Use Only
Permit No.:
- >�—t Department of Fire Services Occupancy and Fee Checked:
=ti-- 4 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]J—•°' 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: Kr/Koval,ov✓f L, Date: !y////gq
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): /1 i'dts l r i 1 j . Or YNta•iu,11t Pori-� OAUnit o.:
Owner or Tenant: Ph,'f i' c . AFI,`�be,�l 94 f lttarl:
Owner's Address: I! !} e, e, t /4 gr",„�t h e/'A�(,'F''�Qaj,s' Phone No.: / q I y s! L( o ciyoz
Is this permit in conjunction with a"building permit?(Check appropriate box)Yes❑ No ✓[Permit No.:
Purpose of Building: , (eOh t Utility Authorization No.:
Existing Service: 00 Amps i2o/ est4O Volts Overhead❑ Underground No.of Meters: /
New Service: Amps / Volts Overhead El Underground❑ No.of Meters:
Description of Proposed Electrical Installation: it./i',--e_ roo.4 tt,i kft=-`-,-dam+
L./IV?, I— 11r 0,-. . 1A�eY.. ./`"-r trl i 5 4,'-
Completion of the following table may be waived by the Inspector of Wires.
No.of Receptable Outlets: a l4 No.of Switches: l a , Generator KW Rating: Type:
No.Luminaires: 'g No.of ecessed Luminaires: ,e. 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:pi 6 p Total Tons: Fire Alarm System El No.of Devices:
Swimming Pool:In-Grad.El Above-Gmd.❑ Hot-Tub❑ 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 Devicesp
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment:R E C Eel V 0
No.of Modules: Roof-Mount❑ Ground-Mount❑ Level I ❑ Level 2 El Level 3 0 Rating; ".._
OTHER: JUN 112024
Attach additional detail if desired,or as required by the Inspector of Wires BUILDING L E PA R T M E N T
Estimated Value of Electrical Work: / /O 0 (When required by mtuieip lieu)_. ____
Date Work to Start: (,t/i(//.y Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: Kc.e•t liorlei E I. .c '!G, 1 A-1 ❑or C-1 0 LIC.No.:
Master/Systems Licensee: LIC. No.:
Journeyman Licensee: Kt t,n I-1 t-or'04vN LIC.No.: 5 io/ a
Security System BusinessBu requires a Division of Occupational Licensure"S"LIC. a S-LIC.No.:
Address: -_( //i er—s E34 R.4 I rN-i't' ,1,,A- 0 a„,,,,--
Email: Ki„„I'f 8 rptt,✓1 Op
if"Mout' ,(�7rti Telephone No.: 5-0 $"a 01f/ j 4
I certify,under the p "r'and p tiesof perjury,th the information on this application is true and complete.
Licensee: Print Name: KA...e 5 i,o •'1 Cell.No.: G(0 7 ^3 f1--SOK,
INSURA. CE C VERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee
provides proof of liability including"corn eted operation"coverage or its substantial equivalent.The undersigned certifies that such coverage
is in force and has exhibited proof of 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 El
Owner/Agent: Tel.No.:
Signature: Email.: