HomeMy WebLinkAboutBLDE-21-004501 •
o• '� `k Commonwealth of Official Use Only
ETIP
Massachusetts Permit No. BLDE-21-004501
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
JRev.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:2/8/2021
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) 30 VIRGINIA ST
Owner or Tenant CERBONE JOSEPH TRS Telephone No.
Owner's Address CERBONE MARCO TRS, 76 BELLEVUE ST,ANDOVER, MA 01810
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 (13 Panels add on to existing system)
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 0 Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No
No.of Devices or Equivalent
HeatersWater KW No.of No.of Data Wiring:
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 ❑ 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
Commonwea/ih o///Ia ssacluidetb Official Use Only^
—'(�U t
IrU -,et cc�� l Permit No.
. ...Department o _tire�ervice4
1 1Occupancy and Fee Checked
�; c 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), 27 CMR 12
(PLEASE PRINT IN INK OR TYP ALL INFORMAT Date: ( 1 —I
•
City or Town of: (� (�m To the Inspector of Wires:
By this application the undersigned es notice of his or her intention to perform the electrical work described below.
Location(Street&Number) t ti n SL-
Owner or Tenant V Telephone No. S2.21 U Y
Owner's Address 6U
Is this permit in conjunction with a building permit? Yes . No 0 (Check Appropriate Box)
J f)Purpose of Building we I Utility Authorization No.
Existing Service 1( Amps i 2--�(46zelts Overhead❑ Undgrd 0 No.of Meters t
C New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
► C1 l l 1 3 .ro�� Irc�►
c Co (c�v pC A\mot s - c( of\ s- s .z+.�
Completion of the following may be waived by the Inspector of Wires.
0 No.No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Transformers KVA
(3 No.of Luminaire Outlets No.of Hot Tubs Generators KVA
v1 No.of Luminaires Swimming Pool Above r-i In- ❑ No.of Emergency Lighting
grnd. grnd. Batte 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. Tonal No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: " ""'""' Detection/Alerting Devices
.. 7 No.of Dishwashers Space/Area Heating KW Local 0 Municiponnectional 0 Other
C
No.of Dryers Heating Appliances KW Security Systems:*
a . r
• j N Equivalent Y
No.of Water , No.of No.of Data V)y ,,g;
Heaters
Signs Ballasts NO. • • 'ces or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Teleco, i i unications Wiring:
No.OfI •�es�r Equivalent
- .."0._ ii
OTHER: a--
t — , Cs,_. Attach additional detail if desired,or awed by the Inspector of Wires.
Estimated Value o Elec 'cal Work: (When required by municipal polio j
Work to Start: 2g' I Inspections to be requested in accordance with MEC Role I' upon completion.
INSURANCE C RAGE: 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 0 OTHER 0 (Specify:)
I certify,under the airs and penalties of perjury,that the information on this application is true and complete.
i \ FIRM NAME: i ` 4-P/ LIC.NO.:
1.� Licensee: Signature LIC.NO.: 1 "-- �e-i\'
E (If applicable,enter exempt"in the license number line.) Bus.Tel.No.-
Address:OAS 1,141' Si-ahet‘ Sl1 (tva TQ,v
C� �' C) Alt.Tel.No.:
*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:$
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E.2 m y Notes m INSTALLER NUMBER:1.877A04Al2g VF�F■i�"SOIC.�r Cerbone VIRGINIA
A Page 170848 15688A 30 VIRGINIA ST
—� Acc MA 02673
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Yarmouth,MA 02673
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