HomeMy WebLinkAboutBLDE-24-662 expired 4/24/24,6:35 AM about:blank
Commonwealth of Massachusetts oF� Y
Town of Yarmouth
ELECTRICAL PERMIT l` f
Job Address: 21 PUTTING GREEN CIR Unit:
Owner Name: Mike Malieswski
Owner's Address: 50 OAKVALE RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.: 17152155
Is this permit in conjunction with a building permit? No Permit Number: BLDE-24-662
Existing Service Amps/Volts Overhead❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Replacement service
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: $ 1 Work to Start: April 22, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: JOHN R HASSAY License Number: 38186
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: SOUTH DENNIS, MA, 026603717 SOUTH DENNIS MA 026603717 Fee Paid: $50.00
Email: rhassay_@comcast.net Business Telephone: 508-221-0849
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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IRFCEIvED
..' _ ommonwealth of Massachusetts Official Use O I
=:_ ri Permit No.: (��"—�p�'��
. el-� ,24 Department ofFire Services Occupancy and Fee Checked:
U'l - -__ r— 139 �' OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
BUILn _1 �t_ ,,y. rNT
BY ,.- yam''-�'� • - ICATION 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: 8-7ri ) 1-3 '2.02_k
To the Inspector of Wires: By this applicaton,the undersigneddjives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): 2-1 rt)"("t I j,` eireev� Cive (� Unit No.:
Owner or Tenant: k t V e (�q ) ;� tJ
g•. g-. i Email:
Owner's Address: 5o (7a vale_ 1 �✓etviA,`,if 11 ,4, O 170( Phone No.:(,, 11 _ �j 62 —O J 3 S
Is this permit in conjunction with a building petn-it?(Check appropriate box)Yes❑ No Permit No.:
Purpose of Building:g: P�2 I t ON Uti 'ty Authorization No.: (Z ( — 6-2 I-- 55
Existing Service: I 0 0 Amps 4 / . -(VVolts Overhead[Underground❑ No. of Meters:
New Service: 1 O 0 Amps (2-0 / Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: 42f' ) L4�e____. SP�1! t I L C e
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❑ 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 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 E ectrical Work: (When required by municipal policy)
Date Work to Start: r 7-2_ Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: A-1 ❑ or C-1 ❑ LIC. No.:
Master/Systems Licensee: LIC.No.:
Journeyman Licensee: Sck__ 7' LIC. No.: 137 ( �
Security System Business requires a Division of Occupational Licensure"S.'LIC. S-LIC.No.:
`L Address: /ir/Act y,e-1/ e, �i1(,_
Email: ��5 SGtT 1Co c 5- li( P _ Telephone No.:50 — -2-7( — i-{Oj
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
Licensee: 4k41e4 Print Name:07.)(4.4-k_ 2 4*(3S4 Cell. No.: 5-7:) . 2-2 t 0 .`t
INSURA CE COVERAGE: Unless waived by the owner,no permit for the performance oftrical 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 fraloBOND ❑ 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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