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HomeMy WebLinkAboutBLDE-23-19610 10/2/23,2:20 PM ��I J about:blank . Commonwealth of Massachusetts o Yam" • Town of YarmouthAi tea' ' rr■ , c ELECTRICAL PERMIT ,�� - ` Job Address: 45 WILLIAMS RD Unit: Owner Name: MURRAY JOHN MURRAY JEANNE Owner's Address: 6 WOLCOTT RD Phone: Email: Purpose of Building Residential Utility Authorization No.: Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19610 Existing Service Amps/Volts Overhead ❑ Underground❑ No. of Meters: New Service Amps/Volts Overhead 0 Underground❑ No. of Meters: Description of Proposed Electrical Installation: Permitting work done in the past. (Fee may change) 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 0 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: $ 1,500 Work to Start: October 4, 2023 FIRM NAME: License Number: Master/System and/or Journeyman Licensee: EDWARD 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 ei, ti'75`=-' 026733818 Fee 12. d: $75.00 Email: pinchcalllynch@icloud.com Busine Tele. a • e: 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: PATT40....., ..ksiD is uck (o( ( 1w, ,„0„,-,€ — s- -L irez st4, ,,,i,, ,---.. i&-se.....,,,, C ..n►0 c cm 6tt44.c,t) 1/1 about:blank J • RECEIVED .:1 OCT 0 to&3n• ealth of Massachusetts Official Use Onl ._:__ = Permit No.: -1 C 1✓ -_"A1t!--=1' L D I N G D E PA R I e a ' I ent of Fire Services Occupancy and Fee Checked: i'_ - " - i - . • re PREVENTION REGULATIONS [Rev. 1/2023] - .';'' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), C R�12 00 City or Town of: YARMOUTH • Date: To the Inspector of Wires: By this appLcati n,the,un rsigned gyGI noti f his o her intention to perform the electrical rk described below. Location (Street& NuWber) ftc4 Unit No.: Owner or Tenant: , r_0144 W//V r Email: , Owner's Address: 45. Phone No.: 7(f" 797 Is this permit in conjuncts with a uilding permit? (Check appropriate box) Yes Ff No ❑ Permit No.: Purpose of Building: /�Gri'e //j Utility Authorization No.: ExistingService: Amps / Volts Overhead 0 Underground No. of Meters: ❑ g ❑ New Service: Amps / Volts Overhead 0 Underground No of Meters: . Descriptio9 of Proposed Electrical I stallation: — PG. (1\ trt U/14 .,i1M4 0 -e (74 1 , C c/5 Completion of the following table may be waived by the Inspector of Wires. No. of Receptable Outlets: No. of Switches: ^ Generator KW Rating: Type: A 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: 1 Fire Alarm System ❑ No. of Devices: _ Swimming Pool: In-Grnd. ❑ Above-Grnd. ❑ Hot-Tub 0 No. of Self-Contained Detection/Alerting Devices: No. Oil Burners: No. Gas Burners: Video System 0 No. of Devices: No. Air Conditieners: 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�j ❑ Ground-Mount 0 Level 1 0 Level 2 ❑ Level 3 0 Rating: 1 pTHER: G i,7er c1 �rggc �'/4P� ,'I7,C edre0, 1 c'lt7 fie Pf � 77 ttaeh a ditidnal t 1 r d i I s rpcired the In ector Wire'°yEstimated Value of Electri al W r . I , (20 (When required by municipal policy) Date Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. FIRM NAME: p,4 (,.yr7C 4 A-1 0 or C-1 ❑ LIC. No.: Master/Systems Licensee: LIC. No.: Journeyman Licensee: jt te/t7rLsf4 : LIC. No.: 3c6oqf SecuritySystem Business requires a Division of Ocu ati nal " "Y q p o Licensure S LIC. S-LIC. No.: Address: ' ' . ' .0 A- . ', A 1' lb , ' t" . _ r Email: / , ,I . ' i a C. t i 0,e,i Telephone No.: 7 7 9--2,z99 Uig I certify, unen the pain a penalt' of perjury, that the in or alion on thty4 ' applica on is true and complete. (►�J Licensee: Print Name: � '/'(,� C Cel!. No.:? 7r " �' 7INSURANCE COVERA E• nless waived bythe owner no for the performAnce of lectrical work mayissue unless the licensee permit 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 a to the permit issuing office. CHECK ONE: INSURANCE BOND 0 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.: _' ` _~ - . � `..` . . / ` ` ^ ' ` . ^ .- ` ' ,� ` ` *^ ` � ` ` ^ � ` . � � ^ . . `- ` ` , . ' � . ` _ _-_ ` ` ^ � ' ' ^ � ' � ` � ` � ` � . ` ~� , ^ �. ` �� � �^ .. . � ^ � x ` � � ' � ' ." ' ' ^� . . . � . ^ ° ' . . ^ � ~ . . - ` � ` ' ^ ^ . ~ . � � . . . � ` .� . ^ � ` � � � - - - _ -- _-- - - __-�