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Home My WebLink AboutBLDE-21-006871 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-006871 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:5/26/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the eectncal work described below. Location(Street&Number) 216 HIGGINS CROWELL RD r 0 1, Owner or Tenant NEVES RUYTER Telephone NO .0 Owner's Address 2 SHEFFIELD ROAD,WEST YARMOUTH,MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check App t 0 Purpose of Building Utility Authorization No. /^{ Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meter New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity O Location and Nature of Proposed Electrical Work: Installation of solar PV system(22 Panels 7.15 KW) Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons • No.of Waste Disposers Heat Pump Number Tons , KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired.or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. 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. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LLOYD R SMITH Licensee: Lloyd R Smith Signature LIC.NO.: 15688 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 1ST ST,MELROSE MA 021764010 Alt.Tel.No.: *Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$150.00 ememonwealth o/MaMackikeild Official Use On P`== 6Permit No. e.Q't ' CI ( 1 -zip_ : s - '— 2)epartnient o 3ire ervice5 = =1t ? Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] '-,.. ,. (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC) 527 CM 1 .51...., (PLEASE PRINT IN INK OR TYP L INFORMA ) Date: S 1 City or Town of: V� 0L.) To the Inspector of Wires: By this application the undersigned ves notice of his or her intention to perform the electrical work described below. Location (Street & Number) 2 I � H ► S CroiLeA 1 1�4 Owner or Tenant _16sQ, 1 1 a .e\}C 3 Telephone No.n&t. tea,! VD._ Owner's Address CL E C C, U Is this permit in conjunctiov with a building permit? Yes a No ❑ (Check Appropriate Box) Purpose of Building tk...›e I t I Utility Authorization No. Existing ServiceKn Amps 1 \ Go is Overhead ❑ Undgrd ❑ No. of Meters I New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: t .S 1 i - r ' SO VA, V e sj = 1V--- Completion of the following table may be waived by the Inspector of Wires. No. otal No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans Tranof Tsformers KVA p Tr No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ No. of Emergency Lighting grnd. grnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. Detection and Initiating Devices No. of Ranges No. of Air Cond. Total No. of Alerting Devices Tons No. of Waste Disposers Heat Pump Number Tons KW No. of Self-Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other ►,� Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. H dromassa a Bathtubs No. of Motors Total HP TelecommunicationsofDevices Wiring: g: y g No. of or Equivalent OTHER: 1 Cu Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of lectri al Work: 1�\ �Q . (When required by municipal policy.) Work to Start: 1 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE CO RA E: 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. CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) I certify, under hpains and pe ties of pe 'my, that a information on t ' application is_ true and complete. FIRM NAME: 1 t G{,�/ �/ LIC. NO.: Licensee: �(; 4 - S IY1 :01 Signs C i F__ MC. NO.: 1 'S-Gls'‘n (If applicable, enter "exempt" in the license number line.) �+- Bus. Tel. No.: � Address: S S andi I S ) Gl..)rf1 6TTOO Alt. Tel. No.: LA, - (37 *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. 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 Signature Telephone No. I PERMIT FEE: $ .. 1 rt111‘ i-ev . G \C .m 12 ' €. Le (i) 0 . h„-1 11 0 ,11c . ,40--) .