No preview available
HomeMy WebLinkAboutBLDE-22-007373 Commonwealth of official Use Only >L ►, � or � Massachusetts Permit No. 13LDE-22-007373 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:6/22/2022 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) 92 ASTOR WAY Owner or Tenant Rose Foust Telephone No. Owner's Address 92 ASTOR WAY, SOUTH YARMOUTH, MA 02664-1906 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(22 Panels 7.81 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ton Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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.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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $150.00 t CDF- Commonwealtho7Vaa�achu ells Official Use Only 2 iii c� L i~ re t l o .7 S Permit No. N f^ y epar meal cre ervace6 •�2� 4 j n. a*. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked W 1 W [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK RKo All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 -I (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: m City or Town of: Y `� UI..h f 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& mber) Q Owner or Tenant Owner's Address ` Q Q Vp Telephone No. Is this permit in conjunction with a building permit?.l Yes*Er No Purpose of Buildingj� ti` ❑ (Check Appropriate Box) t i ` Utility Authorization No. Existing Service /00 Amps Ion Volts Over head Er Undgrd❑ No.of Meters I New Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1 pho-oVollnic, Qaior 9tplems ; c2,Q petre.ts 7.1/ Kw Completion of the following table may be waived by the Inspector ofWires. No.of Recessed Luminaires No.of Ceil.-Sus . No.of p (Paddle)Fans 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 j FIRE ALARMS (No.of Zones No.of Detection and No.of Switches No.of Gas Burners i No.of Ranges Initiating Devices Total No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number f Tons I r KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection DI Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent HeatersK ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Telecommunications Wiring: Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Valu of e 'cal Work: l3,71l i5 to (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 0 OTHER I certify, under t ❑ (Specify:) p 'ns and pen Ides of perju7sr ,that the information o thi pplication is true and complet. Y1 FIRM NAME: VV1 SY $� �� -k-t or LIC.NO.:Licensee: . f Signature LIC.NO.: 1 applicable Hier` em t' c the licanse nu ber 1i e„L. / �y�*7 Address: (y�5,r (/l _ C,�IC�f_Srl iflfJ, i['✓(.�ntc� r :Mg , t.lv !�C Bus.Tel.No.: M . C4 *Per M.G.L.c. 147,s157-61,security work requires Department of Public SafetyAlt.Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability Lin. No. required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 oinsurance n r coverage normally a 11 nt. Owner/Agent Signature Telephone No. PERMIT FEE: $ •