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HomeMy WebLinkAboutBLDE-22-005634 Commonwealth of Official Use Only fit,. , Massachusetts Permit No. BLDE-22-005634 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:4/4/2022 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) 60 CAPT LOTHROP RD Owner or Tenant Virginia Pereira Telephone No. Owner's Address 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 ❑ Undgrd ❑ 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(30 Panels 9.75 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- o 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 ❑ 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 Signs 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $150.00 Po_f\u„ -7-6 6-E-, kepolaa) / R .E C y Commonwealth ® Official Use Only ornmoruvea o as�ac u�elt� � [ � j c� c7 mit No. t%Z� ,r' -' 2eparlmenl of.. ire Services APR . Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [RevPer. 1/07] (leave blank) BUILDING - °;,.. MEN ray. APP.. UCATION 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: 3-Q q • I(p(Y City or Town of: (((rtYU]tt To the Inspector of Wires: By this application the undersigned gives notic'r of his or her intention tofpe orm the electrical work described below. Location(Street&Number) G 0 CQ (ai n (ohm /cJh Owner or Tenant i r into, oPr6 cl Telephone No.TIU-qqy-03 Owner's Address CIeiS �amve O Is this permit in conjunction with a building permit? Yes No El (Check Appropriate Box) �G Purpose of Building rtti Utili Authorization No. i Existing Service /UQ Amps / Volts Overhead Undgrd❑ No.of Meters 1 New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity y�� ,��1 Locati and Nature of Proposed Electrical Work: Ins-c I Qj i( d rC r' V p]led pha-mottnic. or Si Stems , 3C pants 9,75 Kcd3 Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf T Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency cy 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 g Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ Other p Connection No.of Dryers Heating Appliances KW Securi No s:* of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent Wiring: No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNo.of Devices or Equivalent OTHER: c� Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Valu o cal Work: I ICU, (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 cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under t p 'ns and pen ties of perjury,that the information on this application is true and complet. FIRM NAME: LIC.NO.: 1 Licensee: , Q Signature LIC.NO.: �F�� (If applicableenter"e em t"i the''��li�cce�nse nuRber li'`e.,,L.. l �y��] p Bus.Tel.No._ 2:.ng'. iLl Address: (2�6• min SL�Id,Srl L IIXJ1 I U(jil c)fl t MP , (NYC O C Alt.Tel.No.: *Per M.G.L.c. 147, 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)❑owner ❑owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. 3D DDZp3< C 0 0-0 mmm0� 0 Z m 2 z O m m m m r m C pm ^_ 0 <-1 Oz.. cam `T. 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