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Home My WebLink AboutBLDE-22-000816 (2) Commonwealth of Official Use Only _ i. , Massachusetts Permit No. BLDE-22-000816 • 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:8/12/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perforZelectrical work des�ibed below. 3J Location(Street&Number) 16 JACKSON AVE $ . �=.I vr a5 Owner or Tenant Telephone No. Owner's Address 16 JACKSON AVE,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. (p?j<kg57 Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of solar PV system(32 Panels 10.4 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 grnAboved. ❑ gk rnd. ❑ No.of Emergency Lighting Batery 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 ❑ 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 Siens No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total lIP 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 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 A-t n. 12- 1 D 9S /21 A- a f't 1 Ef) Commonwealth_l M h �Ocfficial Use Onlyg P_= —•t '7 Permit No. �.'�2-7,-" l Li, _-•. ` 2epartment(rim SIOViCal t'%v' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS •�,;��,�' [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECT ICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 MR 12.t1� (PLEASE PRINT IN INK OR ALL INFO Date: City or Town of: \ 6A,,,i' (), To the Inspector of Wires: By this application the undersi ui gives notice of his or her intention to perform the,/ lescnbed below. Location(Street&Number) ' Q(Th t Owner or Tenant krj� s J i O „.S. Telephone No.S-(r)Y -2_42-Z2 Owner's Address I "e., C Is this permit in conjunction with a byilliag permit? Yes)l No ❑ (Check Appropriate Box) Purpose of Building CIAA.PI ` ( ! A Utility Authorization No. Existing Service'(`3 Amps [U/-z. C . Overhea „ 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: 1 n_S I S6 \ GL rc (1-t-' S C) • Completion of the following table may be waived by the Inspector of Wires. .oTotal No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Tf Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting 'wild. 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. Toon�s No.of Alerting Devices No.of Waste DisposersHeat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Conietio n ill Other Connection No.of Dryers Heating Appliances KW Security Systems:* ryNo.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.H drom a Bathtubs No.of Motors Total HP TelecommunicationsNofDevices or qu Wiring: y as�g No.of Devices Equivalent OTHER: Ce Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value o E - 1 Work: tza (When required by municipal policy.) Work to Start -' 2 I Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO ERAGE: 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 ce.Yify,under the pairss and penalties of perjury,that the information on t ' a ' 'aw is true and complete. FIRM NAME: L IV1 n t retc; - ,- ( C.NO.: Licensee: I S 1 Signatu . I. 4 �(e 3�-1 (If applicable,enter"exempt"in the 1' line-) AAA_ Bus.TeL No.- Address: Address:( I tm (h (�) _ tZ \61 h H u / Ctt.W\ cerso Alt.TeL No.: C`1 *Per M.G.L.c. 147,s.5 -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:$