HomeMy WebLinkAboutBLDE-23-19764 expired 11/1/23,5:54 AM about:blank
Commonwealth of Massachusetts of• YAK
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AftTown of Yarmouth � , o�.
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ELECTRICAL PERMIT ` �,^ y. !' .
Job Address: '50 NEPTUNE LN Unit:
Owner Name: GALLAGHER ANDREW J GALLAGHER KAREN L
Owner's Address: 9 WALLBRIDGE RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19764
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
Description of Proposed Electrical Installation: Septic pump & alarm
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: 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 Syslems: 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: $ 500 Work to Start: November 1, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: CHARLES F' GALLAGHER License Number: 35141
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Worcester, MA, 01604 Worcester MA 01604 Fee Paid: $75.00
Email: gallagherc3737@gmail.com Business Telephone: 508-864-2720
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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RECEIVED
Commonwealth of Massarh s@Jsj 31 2023 Official Use Only
Permil No.: LZ3—1q 76if
E__Isl<fe Department of Fire Servi s. Occupancy and Fee Checked:
C.-',I IF; BOARD OF FIRE PREVENTION RedithjaMT'n W. /20231
— APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 Ct1R 12.00
City or Town of: YARMOUTH Date: /a/3//13
To the Inspector of Wires:By this a licatiS n,the dersigned gives notices of his or her intention to perform the electrical work described below.
Owner
(Street: A o ��G/ / yl E �H/1 C Unit No.:
Owner or Tenant: �/ ow G. pL ,t" Email: J
Owner's Address: Phone No.: of JO 7'3CV
Is this permit in conjunction with f bu' ing p Emit?(Check appropriate box)Yes❑ No❑Permit No.:
Purpose of Building: .S '1 f y fig,* Utility Authorization No.:
Existing Service: Amps J/ Volts Overhead 0 Underground 0 No.of Meters:
New Service: Amps_/_Volts y Overd 0 Underground❑ No.of Meters:
. Description of Proposed Electrical Installation: . „,/„ !'.7 7f
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:
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-Gmd.0 Above-Grad.0 Hot-Tub 0 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 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 I❑ Level 2❑ Level 3 0 Rating:
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electri al ork: lid (When required by municipal policy)
Date Work to Start: a 3 Inspect ns to be requested in accordance with MEC Rule 10,and upon completion.
1
FIRM NAME: _ 4/rrs r 4�4ty 44VEC///C//1 A-1❑orC-1❑LIC.No.: 3/57&
Master/Systems Licensee: LIC.No.:
Journeyman Licensee: [`ji/.. °5 i 6j5/lygkr LIC.No.: is-/yl E
Security System Business requ es a Divisi n of Occupatioi{al Licensure"S"LIC. S-LIC.No.:
Address: 173 57-, l 4l/ t Af< �1�. dice Y / �7
Email: (9of /A H e c ar d Telephone No.:______eZ/__
I certify,under the Jpainss and pena/!Iles of per ry,that the infor on n this a plicatio/p is true and complete.
Licensee: (rev?'' /t L q�/WAel Print Name: Gg47 6/fq/Ja Cell.No.:
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 0 Specify:
OWNER'S INSURANCE WA VER: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 0 Owner's agent 0
Owner/Agent: Tel.No.:
Signature: Email.: