HomeMy WebLinkAboutBLDE-24-766 5/13/24,4:44 PM � about:blank
ZL � Commonwealth of Massachusetts F• y- %
*� Town of Yarmouth rz fcA,.... • 0'�,
i' ELECTRICAL PERMIT �'MA '1�„
Job Address: 8 CANARY LN Unit:
Owner Name: JACQUES DANIEL
Owner's Address: 132 CARRINTON RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-24-766
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground ❑ No. of Meters:
Description of Proposed Electrical Installation: Kitchen and living room
No. of Receptacle Outlets: 12 No.of Switches: 6 Generator KW Rating: Type:
No. Luminaires: 5 No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating:
No.Appliances: 1 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-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: $ 1 Work to Start: May 7, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: EDWARC M LYNCH License Number: 35609
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: WEST YARMOUTH, MA, 026733818 WEST YARMOUTH MA
026733818 Fee Paid: $75.00
Email: danjacques@jnexus.net Business Telephone: 774-208-8338
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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1.mmunonwaa(h oil Maa s:chime&u Officialj lU te 01. E
ti -et ryry,, cc�� (, Permit No. Z"l—
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. 1, v Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/07} (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTR CAL WORK
r All work to be performed in accordance with the Massachusetts Electrical Code(ME 7 MR 12.00
1 t; (PLEASE PRINT IN INK OR TYPE ALL 1NFORON) Date: 5 /
H City or Town of: To the Inspec or o Wires:
.t By this application the undersigned qf'4k)t(JY.7.
s notice of h her intention to perform the electrical work described below.
✓ Location(Street&Number) -- G � C.
Owner or Tenant pQ r Q q, . Telephone No. Lt/3- ^ / 7 7
U Owner's Address ) e.
t, Is this permit in conjunctio ith a b lding permit? Yes iz; No ❑ (Cheek Appropriate Box)
e" at" Purpose of Building pwell i'/10� Utility Authorization No.
u u V
ru
. N` Existing Service `e d Amps ( / J--eir olts Overhead Undgrd❑ No.of Meters
S` New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
", • Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: f T�4 p4 aid �/1'/'4 G� / 170 417
vl `Completion gothefollowingtable may be waived by the lnsector of Wires.
No.of Total
` No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans / Transformers KVA
=',, No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Na.of Luminaires Swimming Pool A Qrbond.ve ❑ gtttIn-d. ❑ No.of Emergency LIM
.Battery Units C F D
No.of Receptacle Outlets r 2.-. No.of Oil Burners FIRE ALARMS No.of Zones ,'._._XF_
•No. �-
No.of Switches No.of Gas Burners of Detection MAY 0 9 20?Initiating De ices
11,1 No.of Ranges No.of Air Cond. TOes No.of Alerting$vicesi I N G LIE UAR`MEN T
No.of Waste Disposers Heat Pump Number Tons KW 'No.of Self-Conte ne :
Totals: .. Detection/Alertin De..T ee —'-T _
No.of Dishwashers / Space/Area Heating KW Local r--1 Mysa eeptian ❑ Other
No.of Dryers i Heating Appliances KW No. f SysteDevicms:*
or Equivalent
No.of Rioter KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydroneassage Bathtubs No.of Motors Total HP Tel No.of Devicesons or Wiring:
OTHER:
Attach additional detail if desired.or as required by the Inspector of Wires.
Estimated Value o cat W rk: (When required by municipal policy.)
Work to Start: 3- Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE CO GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides p f 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 BOND 0 OTHER ❑ (Specify:)
I certify,under the pains and nahies of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:
Licensee: Signature LIC.NO.:316' h
(if applicable nt e e tiat the license r line); Bus.Tel.No.-
Address: l' Aft.Tel No.:777-dor.g.?3,e
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic,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 requitement. I am the(check one)0 owner ❑owner's agent._
Owner/Agent PERMIT FEE:S
Signature Telephone No.
j7E77 E L2W -24-61
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