HomeMy WebLinkAboutBLDE-24-122 1/24'__'.,6:11 AM about:blank
t 11) Commonwealth of Massachusetts og �
* Town of Yarmouth � '
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ELECTRICAL PERMIT A '
Job Address: 11 GROVE ST Unit:
Owner Name: QUINLAN DONALD F (LIFE EST)QUINLAN PATRICIAA(LIFE EST)
Owner's Address: 11 GROVE ST Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-24-122
Existing Service Amps L Volts Overhead ❑ Underground ❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: adding 8 outlets in sunroom.
No.of Receptacle Outlets: 8 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.El 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: $650 Work to Start: January 23, 2024
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: MATTHEW GORDON License Number: 55830
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Dennis, MA, 02638 Dennis MA 02638 Fee Paid: $50.00
Email: MATT.G.GORDON@GMAIL.COM Business Telephone: 508-680-6077
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the
licensee provides proof of liability insurance including "completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
INSURANCE:
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. IMPORTANT
A SEPARATE PERMIT IS REQUIRED FOR THE INSTALLATION ,
OF SMOKE DETECTORS - FIRE ALARM INSPECTIONS ARE
PERFORMED BY THE FIRE DEPARTMENT HAVING JURISDICTION
commonwealth of Massachusetts Officialse Opl
:_— Permit No.:
1=Ai=f Department of Fire Services Occupancy and Fee Checked:
trtrti_ BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
-. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massashusetts Electrical Code (MEC), 527 CMR 12.00
City or Town of: awn 17e;t'1411001-h Date: / /20L3
To the Inspector of Wires:By this application,the undersned gives notices of his or her intention to perform the electrical work described below.
Location(Street&Number): I I Or b V .7-7 6 r Unit No.:
Owner or Tenant: P1 v, P a s e r 1,41 to YlA Email: P h, r ozy hike,/C)3 i'Ytcti 1- c-N4,\
Owner's Address: Phone No.:
Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No❑Permit No.:
Purpose of Building: /iov\i' Utility Authorization No.:
Existing Service: Amps / Volts Overhead❑ Underground❑ No. of Meters:
New Service: Amps / Volts Overhea ❑ Underground❑ No.of Meters:
Description of Proposed Electrical Installation: r ei A I h 6 b v♦T 1 e%$
j In 3 0 to Coo IV)
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 0 No.of Devices:
Swimming Pool:In-Grnd.❑ Above-Grnd. 0 Hot-Tub❑ _ 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 0 No.Crfe�ervi�cest
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equi C E I V E
No.of Modules: Roof-Mount 0 Ground-Mount 0 Level I 0 Level 2 0 Level 3 ❑ 'Rating:
OTHER: i [ JAN 2 2 2024
Attach additional detail if desired, or as required by the Inspector of Wires. RI I a HI N,_a )E PAR I MENT
Estimated Value of Electrical Work: "5(.2 (When required hty.niunicipal.o
Date Work to Startt:j�I /2 3/1_3 Inspectio s to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: J 1� 1 nil/ t p i'0d NA A-1 0 or C-1 0 LIC.No.:
Master/Systems Licensee: amyl LIC.No.:
Journeyman Licensee: ✓V? 7/ !� f't,l/ -,�o Y". 6 ✓L LIC.No.: 5--ce 3 0-F
Security System Business requires a Division Occupational Licensure"S"LIC. S-LIC.No.:
Address: • Co C t9 ✓✓_e --CJ m-M ��-h 7- / S
° Jp 6 0.e��'� e0 6077
Email: {N1 �� � � 'r� Z� b'1 1 r��t� I ���✓�� Telephone No.:
I certify,under the pains enalties of perjury, that the information on this application is true and complete.
Licensee: � ✓ — Print Name: /�l''3 �'11i ' Ii Cell.No.:
INSURANCE COVERAGE: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.: