HomeMy WebLinkAboutBLDE-24-578 4/9/24,7:02 AM about:blank
Commonwealth of Massachusetts og ' yA
* . � Town of Yarmouth
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ELECTRICAL PERMIT 4k, 11
Job Address: 30 WIANNO RD Unit:
Owner Name: HUNNICUTT REGINA AND RICHARD
Owner's Address: 30 WIANNO RD Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-24-578
Existing Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
New Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: Replacement gas burner
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 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 0 Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: April 8, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: RICHARD T MCKENZIE License Number: 28006
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: SOUTH DENNIS, MA, 026602359 SOUTH DENNIS MA 026602359 Fee Paid: $50.00
Email: richmckenzie55@yahoo.com Business Telephone: 508-776-3361
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 Only
Permit No.: ,11- 78
'�== i►_=F Department of Fire Services Occupancy and Fee ecked:
=`e= g BOARD OF FIRE PREVENTION k GULATIONS 1
y '� 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: +'-f--2-*
To the Inspector of Wires:By this application undersigned yes notices of his or her intention to perform the electrical work described below.
Location(Street&N er): .3D Wi Cc it a d Unit No.:
Owner or Tenant: /r/ci/-C 74 'eo/4.a /T tlim/C ti 7" Email:
Owner's Address: sq• o Phone No.: cas3-.356 .' 3 y j
Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No❑ Permit No.:
Purpose of Building: lv4 Utility Authorization .:
Existing Service: toe Amps/. /..2 Volts Overhead❑ Underground No.of Meters:
New Service: Amps / Volts Overhead Underground El No.of Meters:
Description of Proposed Electrical Installation: J!(//,tp (5 cv9a/-_,aE'.L
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-Gmd.❑ Above-Gmd.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 Eqi tpia
No.of Modules: Roof-Mount❑ Ground-Mount❑ Level 1 0 Level 2❑ Level 3 cirL_SEIVED
OTHER:
APR 0 8 2024
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Elect ical Work: (When required t y mikila teife0TMENT
s
Date Work to Start: - a Inspections to be requested 'n accordance with MEC Ruh..1-8 wit 0r.••. I
FIRM NAME: i Qirpv / ac1 eAz.i) A-1 0 or C-1 0 LIC.No.:
Master/Systems Licensee: �/y� LIC.No.: Ev
Journeyman Licensee: i4� //<<'J E'-..4/2-itr-.' . LIC.No.:
Security System Business requires a Division of Occu,tionalLicensure"S"LI S-LIC.No.:
5
, Address: cG2 de' Ac / �1J�/J` a_ ' 6.
Email: // ' el7dL Telephone No.: 5 `
I certify,under the pains and enalties of perjury,that the information on this application is true and complete.
Licensee: i / _ ic/' / 1/2i� /
��' � Print Name: � Cell.No.: Sd�-77b'".336
INSURANCE COVERAG . nless 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 s e to the permit issuing office.
CHECK ONE: INSURANCE [BOND❑ OTHER 0 Specify: tdre//.C��.�/1 3L
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 0 Owner's agent❑
Owner/Agent: Tel.No.:
Signature: Email.: