HomeMy WebLinkAboutBLDE-22-002482 Commonwealth of Official Use Only
�` ! Massachusetts Permit No. BLDE-22-002482
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.l/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:10/30/2021
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) 34 HOOVER RD
Owner or Tenant Winifer Ortiz Telephone No.
Owner's Address 34 HOOVER RD,WEST YARMOUTH, MA 02673
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 ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Installation of solar PV system(17 Panels 6 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. rnd. 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/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Eauivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Siens No.of Devices or Eauivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Eauivalent
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: JAMES E PRECOURT
Licensee: James E Precourt Signature LIC.NO.: 12418
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:244 S WORCESTER ST,APT 3,NORTON MA 027663445 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
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C`,4 f— = BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07
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a
w i APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
0
0 All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
c_ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 10/5/2021
Ili ® =' City or Town of: Yarmouth To the Inspector of Wires:
Ce m m By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 34 Hoover Rd Map 29 Lot 176
Owner or Tenant Winifer Ortiz Telephone No. (774)310-0027
Cl +-- I Owner's Address 34 Hoover Rd Yarmouth, MA 02673
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W w I Is this permit in conjunction with a building permit? Yes n No ❑ (Check Appropriate Box)
c i152 Purpose of Building Solar Installation Utility Authorization No.
MEM CM hi I Existing Service 100 Amps 120/ 240 Volts Overhead X Undgrd— No.of Meters 1
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0 New Service 100 Amps 120 /240 Volts Overhead❑X Undgrd ❑ No.of Meters 2
0 V I Z Number of Feeders and Ampacity
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1 (�Location and Nature of Proposed Electrical Work: In'S ,�1(,� Ory of Scor J t c KW t 14
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T MOOQS I No ESS
Completion of the following table may be waived by the Inspector of Wires.
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No.of Recessed Luminaires No.of Ceil.-Susp. TransformersTKVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
e
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
1
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No. Initiatingon Detectionand
Devices
No.of Ranges No.of Air Cond. T nsl 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❑ 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 NofDeieor Wiring:
No.of Devices Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires
Estimated Value of Electrical Work: 1807.85 (When required by municipal policy.)
Work to Start: 10/18/2021 Inspections 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 ® BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Asset One Insurance LIC.NO.:.
Licensee: Summit Energy Group Signature Ali,,� LIC.NO.:
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:�
Address: 793 I ibhpy Industrial Pkwy#250, Weymouth, MA 02189 Alt.Tel.No.:
*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 v
Signature 9Aez ,, /1it�.�lGe Telephone No.3392017769 PERMIT FEE:
Electrician E-mail Address:
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