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HomeMy WebLinkAboutXerox Scan_1121202411021452 AM about:blank Commonwealth of Massachusetts Town of Yarmouth ELECTRICAL PERMIT Job Address: 8 CRUISER LN Unit: Owner Name: CURRAN JOANNE Owner's Address: 20 HARDING LN Phone: Email: Purpose of Building Residential Utility Authorization No.: 14026058 Is this permit in conjunction with a building permit? Yes Permit Nurr)K,JK BIDE-23-19286 Existing Service Amps / Volts Overhead ElUnderground ❑ No. o>> New Service Amps 100/ Volts Overhead ❑ Underground ❑ No. of Me Description of Proposed Electrical Installation: New residence No. of Receptacle Outlets: 40 No. of Switches: 24 Generator KW Rating: Type: No. Luminaires: No. of Recessed Luminaires: No. Wind Generators: Wind KW Rating: No. Appliances: KW: No. Water Heaters: 1 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: 8 Swimming Pool: In-Grnd. ❑ Above-Grnd. ❑ Hot Tub ❑ No. of Self -Contained Detection/Alerting Devices: No. Oil Burners: No. Gas Burners: 1 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 Modules: Roof -Mount ❑ Ground -Mount ❑ No. of Electric Vehicle Supply Equipment: Level 1 ❑ Level 2 ❑ Level 3 ❑ Rating: Estimated Value of Electrical Work: $ 30,000 Work to Start: August 1, 2023 FIRM NAME: License Number: Master/System and/or Journeyman Licensee: DANIEL O 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: $180.00 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: �� WA 4-31 QL'Ur,O kk_�ct(T—Sk:!r, I about:blank 1/1 --K\- Commonwealth of Massachusetts official Use only VMORPR Permit No.: �') Z '' 1 Q'Z,�j 6. Department of Fire Services Occupancy and Fee Checked; BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed..in-aceordance.with the Massachusetts Electrical Code (MEC), 527 C R 12.00 City or Town of: YARMOUTH ' Date: (J To tloe Inspector of Wires: By this Iication, the undersigned gives notices of his or her intention to perform the electrical work described below. Location (Street & Number): $ap yu 6 E ` Ln I J 2 xa/y unit No.: Owner or Tenant: J I) Rnh f, C Q rrN P\ Email: Owner's Address: Phone No.: Is this permit in conjunction with a building permit? (C eck appropriate box) Yes ® No ❑ Permit No.: Purpose of Buildin r rP 1; �Mt (V �U i f%C/ _.._ Utility Authorization No.: CWAO Existing Service: Amps / Volts Overhead ❑ Underground ❑ No. of Meters: New Service: 00 Amps Ido 4Pq,0 Volts Overhead [K Underground ❑ (( No. of Meteors: Description of Proposed Electrical Installation: A)F—) On E Fj}t►-t, [V fit.► s_ i �: �rt �i 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. Appliances: KW: No. Water Heaters: / KW: p No. Wind Generators: No. Transformers: Wind KW Rating: 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. ❑ No. Oil Burners: Above-Grnd. ❑ Hot -Tub ❑ No. Gas Burners: / No. of Self -Contained Detection/Alerting Devices: 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 Modules: Roof -Mount ❑ Ground -Mount ❑ No. of Electric Vehicle Supply Equipment: Level 1 ❑ Level 2 ❑ Level 3 ❑ Rating: Attach additional detail if desired, or as required by floe Inspector of Wires. _ Estimated Value of Electrical Work: DOD. (When required by municipal policy) Date Work to Start: L 1 `LD Z 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: Journeyman Licensee: _ U) i � Q v. LIC. No.: LIC. No.: —:3 aaV F E Telephone No.:. 9 4 j _�" I cernjy, n�ep us� r penalties ofperjury, that file infornoation on this {{a plication is true and complete. License Print Name: v; t t Cell. No.: INSURANCE t VE E: Unless waived by the owner, no permit for the performanc 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 die permit issuing office. CHECK ONE: INSURANCE PQ 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.: