HomeMy WebLinkAboutBLDE-20-005669 Commonwealth of Official Use Only
titli Massachusetts
Permit No. BLDE-20-005669
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:5/4/2020
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. 0
Location(Street&Number) 32 TOWN BROOK RD
Owner or Tenant JANNINI EDWARD J Telephone No. C , Q
Owner's Address 15 KIMBERLEY DR, NORTH EASTON, MA 02356
Is this permit in conjunction with a building permit? Yes 13 No 0 (Check Appropriat
Purpose of Building Utility Authorization No. O it) 0
Existing Service 100 Amps 120 Volts Overhead 0 Undgrd 0 No.of Meters1/1
New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters O
Number of Feeders and Ampacity /
Location and Nature of Proposed Electrical Work: Installation of roof mounted photovoltaic solar systems 8.32kw 26 Pan sZfize1
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- 1:1No.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
Initiatine 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/Alertinc 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 Data Wiring:
Heaters Sins 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: 06/03/2020 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