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HomeMy WebLinkAboutBLDE-22-001894 or ' f Commonwealth of Official Use Only etid ` Massachusetts Permit No. BLDE-22-001894 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked '' [Rev.1/071 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:10/4/2021 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 electrical work described below. Location(Street&Number) 22 GROUSE LN Owner or Tenant Joseph Niemeyer Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of solar PV system. (26 Panels 8.58 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. Totalo No.of Alerting Devices TNo.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 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs 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: NATHAN A ASHE Licensee: Nathan A Ashe Signature LIC.NO.: 21136 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 166 Hunt Rd, Chelmsford MA 018243747 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 my 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 V4:A441,- (411(7ii ie CR144\1\S 'e Leto) 64,_ 1041 . (ommonweaA o`Mame:chaseIts Official Use Only rr'' ��22 � i t4 '� c7 Permit No. �Ci 2apartmen1 oj..tine s ices t( :' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELEC RICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEN 7 CMR 12. (PLEASE PRINT IN INK OR ALL INFO N Date: �� 'a.—I City or Town of: 0� To the Inspector f Wires: By this application the undersigned 'ves notice of his or her intention to perform the electrical work described below. Location(Street&Number) m ito()..T._ Owner or Tenant `1( ph N i-eA-n-E% -4.-er' Telephone No.91 r(On (0� Owner's Address V ( `.n..Q c-) ( Li-e___ Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building CtWe t 1 ( (//- Utility Authorization No. Existing Service 1 W Amps 7C)/ a-faolts 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: n ` 1 2 c0 - ri)Ojf)4---cp ole,/ > . ..--.:c mpletion of the followingtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Tf T Transformers KVAVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmingpool Above ❑ In- ❑ No.of Emergency Lighting grnd. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of No.of Switches No.of Gas Burners No.Initiatinnggon Dete and In Devices No.of Ranges No.of Air Cond. Total g Tons No.of Alerting Devices 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❑ Munnectionnicipal El Other Co No.of Dryers Heating Appliances KW ty Systems:* No.of Water No.of No.of No.of Devices or Equivalent KW 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: CO Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of El 'cal Work: I (�, (When required by municipal policy.) Work to Start: I Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C 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 suc i co .le is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE :! BOND 0 OTHER 0 (Specify:) I certify,under thetpains and, , of petjury,that the information on this application is due and complete. FIRM NAME: y�U n)r 111 q,f N s-to 1 i {/U LIC.NO.: Licensee: (\ ! a ' 1 t P Signature o LIC.NO.: a.t 1 (If applicable, ter exem t"in the license number line. n i Bus.TeL No.• Address: t4 --PLO J ) (1 C- Alt.TeL No.: 3._ 9 *Per M.G.L.c. 147,s. 7-61,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:$ rho,14-Cv • Gha,t,,,pe.-c Q s e ry r . - t-., 3 1 p N gi r & rc a o D 0 f S I W I U w p o W CO O w w lo 5 w o ` / owy § rc a CO o 0 0 o C s CO—wg� S mf _ o 1i KwW w jlo F- W 5 i izZ0)ti '- zz rc 3 > a 11yy o s gay1p® m UN w O ~ 0 0 `1 o o N %Se d4 S WU a w d a a> a a a °o° 0O"2 J z rc. INy > I w Q a $ ? 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