HomeMy WebLinkAboutBLDE-21-002327 Commonwealth of Official Use Only
. E. , Massachusetts Permit No. BLDE-21-002327
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:10/28/2020
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below.
Location(Street&Number) 48 VILLAGE BROOK RD
Owner or Tenant DESMARAIS ROBERT Telephone No.
Owner's Address DESMARAIS HELEN,48 VILLAGE BROOK RD, SOUTH YARMOUTH, MA 02664
Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 07, 04,04, a 'J
New Service Amps Volts Overhead 0 Undgrd z t• s
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Installation of solar PV system(12 Panels 4.0: .4111'
Completion of the following table m th Spector of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of TotalTransformers JA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above 0 In- ❑ No.of Emergency Lighting
jrnd. grid. 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 ❑ 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 Data Wiring:
Heaters Siens 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 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: FERNANDO BLANCO
Licensee: FERNANDO BLANCO Signature LIC.NO.: 22452
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 190 SEWALL ST, LUDLOW MA 01056 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
•
Com,,w,uroa[th o///Iadaact Official Use Only
I. `i �] n Permit No. 15 - _ Z�Z
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Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. i/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in acc c*dsnce with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 10/27/20
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) 48 village brook rd
Owner or Tenant robert desmarais " Telephone No. 856 288 3892
Owner's Address 48 village brook rd
Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) "'
Purpose of Building residential solar Utility Authorization No.
Existing Service Amps I Volts Overhead 0 Undgrd 0 No.of Meters , m
New Servlcg Amps / Volts Overhead❑ Undgrd 0 No.of Meters o
Z l\D
Number of Feeders and Ampacity C co .
Location and Nature of Proposed Electrical Work: installation of 12 roof mount solar panels 4.08 m c <
v
Completion of the followin table may • ved by the hivectd-of 4'
iree
lb Lu
No.of Recessed minaires No.of Ceil.-Su (Paddle)Fans o of • . Total
T;3',10 I e KVA
CI No.of Luminaire Outlets No.of Hot Tubs " 0
No.of Luminaires SwimmingPool Above 0 In- 0 lro. .. e _PI ‘
grad. grad. Battery ''
`.1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARM,�
�. v
't No.of Detection a,,, it)
No.of Switches No.of Gas Burners
"' Initiating Devices
{ + No.of Ranges No.of Air Cond. To
No.of Alerting Devices
No.of Waste rs Heat Pump Number Tons _KW No.of Self-Contained
e Totals: Detection/Alertipg _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 Equivalent
No.of Rratcr No.of No.of
KWData Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent _
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiringg
No.of Devices or Equivalent
OTHER:
5000 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: 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 of perjury,that the information on this application is true and complete.
FIRM NAME: borawski insurance LIC.NO.: 22452
Licensee: blanco electric/fernando blanco signs , %4 ' •� LIC.NO.:
(If applicable,enter"exempt". ! license num*line.) F Bus.Tel.No.: 856 288 3892
Address: 90 sewallst iudiow ma 01056 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
Signature Telephone No. PERMIT FEE:$