HomeMy WebLinkAboutBLDE-23-19860 11/17/23, 1:23 PM \ 7 0
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Comm
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ELECTRICAL PERMIT
Job Address: 39 SKIPPER LN Unit:
Owner Name: JOHNSON CAROL ANN
Owner's Address: 12913 THE WOODS DR S Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19860
Existing Service Amps/Volts Overhead❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: wire finished basement area
No.of Receptacle Outlets: 14 No.of Switches: 6 Generator KW Rating: Type:
No. Luminaires: No.of Recessed Luminaires: 12 No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA:
Space Heating KW: 6 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: $4,000 Work to Start: November 17, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: WILLIAM A TRACIA License Number: 15005
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: BERLIN, MA, 015030219 BERLIN MA 015030219 Fee Paid: $75.00
Email: electracia2@gmail.com Business Telephone: 5086122244
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: NGM
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