HomeMy WebLinkAboutBLDE-22-001462 or Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-22-001462
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:9/14/2021
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) 12 ST ANDREWS WAY
Owner or Tenant Marcy Cohen Telephone No.
Owner's Address 12 ST ANDREWS WAY, SOUTH YARMOUTH, MA 02664
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. (12 Panels 4.02 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 Lig%t'lf� Q
grnd. grnd. Battery Units /V� C
No.of Receptacle Outlets No.of Oil Burners FIRE ALA• o.of
No.ofGas Burners No.of Detect
a �•i o r
No.of Switches Initiatine Devic• Z
No.of Ranges No.of Air Cond. Total No.of Alerting Devi • o
No.of Waste Disposers Heat Pump Number TonsKW No.of Self-Contained
Totals: I Detection/Alertine Devices
Municipal ❑
No.of Dishwashers Space/Area Heating KW Local 0 Connection
No.of Dryers Heating Appliances KW Security Systems:* O
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 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: SOLAR WOLF ENERGY
Licensee: Kyle Zuidema Signature LIC.NO.: 22593
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 771 Washington Street,Auburn MA 01501 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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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).527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9/13/2021
City or Town of: Yarmouth
To the Inspector of Wires:
oBy this application the undersigned gives notice of his or her intention to perforin the electrical work described below.
"• Location(Street&Number) 12 St Andrews Way
Owner or Tenant Marcy Cohen Telephone No.508-258-5890
, Owner's Address 12 St Andrews Way
3 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Residential Utility Authorization No.
o
Existing Service 100 Amps 120/240 Volts Overhead 0 Undgrd i] No.of Meters 1
ew Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters
i, Number of Feeders and Ampadty
• Location and Nature of Proposed Electrical Work: Installing a 4.02kW roof mounted solar array using
,; 12 SunPower 335W panels with built-in micro inverters. Installing empty meter socket for SMART gen meter
v-) Completion of the followingtable may be waived by the inspector of Wires.
got No.of TT
U No.of Recessed Luminaires No.of CelL-Snap.(Paddle)Fans Transformers KVA
{` Generators �A
C; No.of Luminaire Outlets No.of Hot Tubs
Above In- Pio.of Emergency Lighting
4.. No.of Luminaires Swimming Pool grnd ❑ grnd. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones
No.of Detection and
No.of Switches No.of Gas Burners Initiating Devices
1;; No.of Air Cond. Ton No.of Alerting Devices
No.of Ranges Tons
Heat Pump I Number.ITons ].KW No.of Self-Contained
No.of Waste Disposers Totals: Detection/Ale Devices
niate.
No.of Dishwashers Space/Area Heating KW Local❑ MnConnection ❑
Heating Appliances KW Security Systems:*
No.of Dryers Hg pp No.of Devices or Equivalent
No.of WaterNo.of No.of Data Wiring:
Heaters KW Signs Ballasts No.of Devices or Equivalent
Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent
OTHER:
Attach additional detail if desired or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 5,861.40 (When required by municipal policy.)
Work to Start: 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 0 OTHER 0 (Specify:)
I certify,under the pains and penalties ofperjury,that the information on this application is true and complete.186400
FIRM NAME: Solar Wolf Energy LIC.NO.:
Licensee: Kyle Zuidema Signature r V.', LIC.NO.:CS-087491
(lf applicable,enter"exempt"in the license number line.) Bus.TeL No.; 508-839-2222
Address: 771 Washington St Auburn Ma 01501 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)0 owner 0 owner's agent.
Owner/Agent PERMIT FEE:
Signature Telephone No.