HomeMy WebLinkAboutBLDE-24-787- 5/17/24,6:40 AM about:blank
Commonwealth of Massachusetts o • Yea
uTown of Yarmouth
tr
it ELECTRICAL PERMIT
Job Address: 57 DRIVING TEE CIR Unit:
Owner Name: MCCAFFERTY THOMAS
Owner's Address: 57 DRIVING TEE CIR Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-24-787
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Relocate wire
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: Total KW:
No. Heat Pumps: Total KW: Total Tons: 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 ❑ Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 150 Work to Start: May 15, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: JARLATH A GALVIN License Number: 10861
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Yarmouth Port, MA, 026752045 Yarmouth Port MA 026752045 Fee Paid: $50.00
Email:jargalvin@comcast.net Business Telephone: 508-488-7487
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 seinl_,�` .�
t� 4 Permit No.: 1�
>�I► 6' Department of Fire Services Occupancy and Fee Checked:
111_
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
,.td• 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: YARMOUTH_ • Date: M CS L. t f
To the Inspector of Wires:By this appli tion,the undersigned�^gives not' es of s or her intention to perform the electridal-+York described below.
Location(Street&N ber): �?"' • v i'IN - l'e-e. Li1C Unit No.:
Owner or Tenant: ft. I�f J ..p. \) Email:
Owner's Address: hone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes No❑ Permit No.:
Purpose of Building: Utility Authorization No.:
Existing Service: Amps / Volts Overhead❑ Underground❑ No.of Meters:
New Service: Amps / Volts Overhead ❑ Under round❑ No.of Meters:
Description of Proposed Electrical Installation: �pi� 6 t R. Z, -�-QeTr.
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: I 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: Total Tons: Fire Alarm System 0 No.of Devices:
Swimming Pool: In-Grnd.0 Above-Grnd.0 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 0 No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply E gt�nt�t:G` E I V E D
No.of Modules: Roof-Mount❑ Ground-Mount 0 Level 1 ❑ Level 2 0 Level $ r'--1I�� sting:-------'-
OTHER:
MAY 15 2024
Attach additional detail if desired,or required by the Inspector of Wires.
Estimated Value of E trical Wo k: [SO BUILDJNG p plicy) MENT
(When required b�ymuntctpa gohcy
Date Work to Start: CA
2t.I Inspections to be requested in accordance with MEC Rule 10,and upon completion.
/IF
FIRM NAME: ,
at
�q V*LVIN A-I 0 or C-1 0 LIC.No.:
Master/Systems Licensee: , LIC.No.:
Journeyman Licensee: \cv(ct- &Qv., LIC.No.: V0t6
Security System Bus`1Tessequire a Division of ccu ational Lice sure C. S-LIC.No.:
Address: k�EO t`ae - 6 A- &a u* T,f) Q -
Email: �q 4 chi P eQW'viC . r/,- Telephone No.: - 8 `tee 9
I certify,unde� 4 ,a' s penalties of perjury,that the inf nt ion o t f ltisbpplication is tare and complete.
-� a Licensee: I ' t N Print Name C J IN Cell.No.: Oct,.1 I-0 4 of
INSURANC: COVERA E: Unless waived by the owner,no permit for the rformance of electrical work may issue unless the licensee
provides proof .f liability inc uding"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage
is in force and as exhibited proof of same 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❑
Owner/Agent: Tel.No.:
Signature: Email.:
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