HomeMy WebLinkAboutBLDE-23-19967 12/6/23,,8:31 AM about:blank
Commonwealth of Massachusetts o .• Y�i � ,.
Town of Yarmouth cr
ELECTRICAL PERMIT ` 't `
Job Address: 9 SIOUX RD Unit:
Owner Name: CORCORAN ROBERT F CORCORAN KATHRYN M
Owner's Address: 300 MAPLE OAK DR Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-23-19967
Existing Service Amps/Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Half bathroom &bedroom addition.
No.of Receptacle Outlets: 8 No.of Switches: 6 Generator KW Rating: Type:
No. Luminaires: No.of Recessed Luminaires: 4 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: 6
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: $4,800 Work to Start: December 5, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: DANIEL 0 WILKEY License Number: 32288
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: SOUTH DENNIS, MA, 026603744 SOUTH DENNIS MA 026603744 Fee Paid: $75.00
Email: dwilkey396@hotmail.com Business Telephone: 508-360-4636
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 Use AktiLlx
o_ "- PermitNo.: �S ( 7
-' i t Department of Fire Services Occupancy and Fee Checked:
c;—'� -y BOARD OF FIRE 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 527 CMR 12.00
City or Town of: YARMOUTH Date: L ; (0, 3
To the Inspector of Wires:By this application,the and signed gives notices of his or her intention to perform the electrical work described below.
Location(Street& u ber): 9 /.5 /cc LL 5 � \/f)�jy ,-i-`i Unit No.:
Owner or Tenant: tic Co l\ 1 Email:
Owner's Address: Phone No.:
Is this permit in conjunction with a builditl ermit?(Check appropriate box)Yes 0 No❑Permit No.:
Purpose of Building:6,1)i, /—y}li►Iy b; F.I)l t) Utility Authorization No.:
Existing Service: /G't Amps J "/,)?</4 Wits Overhead Igl.. Underground❑ No. of Meters: I
New Service: Amps / Volts Ov head❑ Underground 0 No.of Meters:
Description of Proposed Electrical Installation: U% i i t j C Yo . I3,I44\i 7o/A
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Completion of the following table may be waived by the Inspector of Wires.
No.of Receptable Outlets: 5" No.of Switches: Generator KW Rating: Type:
No.Luminaires: No.of Recessed Luminaires: y 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.0 Above-Grnd.0 Hot-Tub 0 No.of Self-Contained Detection/Alerting Devices: Gj
No.Oil Burners: No.Gas Burners: Video System Y 0 No.of Devices:
No.Air Conditioners: Total Tons: Telecom System 0 No.of Outlets:
No.Energy Storage Systems: KWH Storage Rating: SecuritySystem
Solar PV KW DC Rating: Solar PV KW AC Rating: 0 No.of Devices:
No.of Electric Vehicle Supply Equipment:
No.of Modules: Roof-Mount 0 Ground-Mount
0 Level 1 0 Level 2 0 Level 3❑ Rating:
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: y ,b — (When required by municipal policy)
Date Work to Start:. ,>ea)(2- Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME:
A-1 0 or C-1 0 LIC.No.:
Master/Systems Licensee: LIC.No.:
Journeyman Licensee:7a+"])c�I 1,c':1 t1� q( LIC.No.: 3 , 1>
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.:
Address: .70. ( 14/4}ltirrl c p T 1 N A ,
Email: [��.�t Ley �� �,�� 1 • Telephone No.: 6C _ "1i L�/3(l)
I cert ,u e the ins and enalties of perjury,that the information on this application is true and complete.
License / Print Name: 1
Tv4d IS,/ 14.2 I ii y Cell.No.: -, -1/636
INSURANCE V RA 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❑ 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.: