HomeMy WebLinkAboutBLDE-22-003467 co tiv 'l' Commonwealth of Official Use Only
it-Intio i Massachusetts Permit No. BLDE-22-003467
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:12/20/2021
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) 15 JUPITER LN
Owner or Tenant NASMAN DALE R Telephone No.
Owner's Address NASMAN ANNIE M, 15 JUPITER LN, SOUTH YARMOUTH, MA 02664-4116
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 (16 Panels 5.68 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. 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. Ton Total
No.of Alerting Devices
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 ❑ 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 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: Nathan A Ashe
Licensee: Nathan A Ashe Signature LIC.NO.: 21136
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 166 Hunt Rd, Chelmsford MA 018243747 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
Pt,uca66 649 124-6 (s) (12'6(21% (j:ks P t.,e_
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Commonwealth o/Ma36achuJelle Official Use Only
I_ �t_ / c� Permit No. T---12.---3L-(1,7
�1_ a 2e artmenl o` ire�erviced
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f Occupancy and Fee Checked
\,-:,,,,,,, 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:12/8/2021
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) 1 S —1,, 1 A Cy L fl C)..
Owner or Tenant �f I t (__3('n.. __(1 Telephone No.S CSS(ol,,31 Sa
Owner's Address same as above
Is this permit in conjunction with a building permit? Yes V No ❑ (Check Appropriate Box)
Purpose of Building dwelling Utility Authorization No.
Existing Service'C Amps 11C C 12 21/4-10Volts Overhead❑ Undgrd In No.of Meters 1
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Installation of roof mounted photovoltaic solar systems,
I0I-
(p panels ;---. (� kW
Z ( Com.letion of the following table may be waived by the Inspector of Wires.
�U •w No.of Total
o.--- i o.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA
-, cv I a 'I o.of Luminaire Outlets No.of Hot Tubs Generators KVA
LUAbove In- No.of Emergency Lighting
I o.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units
O
V v o I o.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones
of Detection and
Cem m'
,I o.of Switches No.of Gas Burners No. Initiating Devices
Total
o.of Ranges No.of Air Cond. Tons No.of Alerting Devices
PumNo.of Self-Contained
No.of Waste Disposers HeatTotals Number Tons ' Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection r--1 Other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of WaterKW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.Hydromassage No.of Devices or Equivalent
OTHER:
_J _ CEJ Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work:Cf 8.S ( 2. (When required by municipal policy.)
Work to Start:1/8/2022 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 IR 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:Sunrun Installation Services LIC.NO.:
Licensee: Nathan Ashe Signature -71001.4 ��`l4..,,...'
� LIC.NO.:21136A
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:9785943519
Address: 695 Myles Standish Blvd Taunton MA 02780 Alt.Tel.No.:8573343116
*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
Signature Telephone No. I PERMIT FEE: $