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Home My WebLink AboutBLDE-23-000400 .,. ,,/ Commonwealth of Official Use Only f�` tt4li '� Massachusetts Permit No. BLDE 23-000400 BOAR 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:7/26/2022 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) 23 HARBOUR HILL RUN Owner or Tenant Pat Towle Telephone No. Owner's Address 23 HARBOR HILL RUN, SOUTH YARMOUTH, MA 02664-2120 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 (39 Panels 15 KW)(NO ESS) 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 Tons 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 Connection 0 Other: 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:) ��- VJ �� ' �� I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: JAMES E PRECOURT Licensee: James E Precourt Signature LIC.NO.: 12418 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:244 S WORCESTER ST,APT 3,NORTON MA 027663445 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 i r C � ��Q��,I1ZZl� ED JUl2 5 20 l o eaU&o/rnamaclauac 's Official Use Only • NT c77 C� PcrrTh1NO. 3�'. -CI • i1 Ulf.v UEt'NRT aka of of_tire Jartrke6 + 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: 07/18/2022 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) 23 Harbor Hill Run Owner or Tenant Pat Tnwle Telephone No.508 254 8065 Owner's Address 23 Harbor Hill Run Is this permit in conjunction with a building permit? Yes C No (Check Appropriate Box) Purpose of Building Solar Utility Authorization No. Existing Service 150 Amps 120 / 240 Volts Overhead Undgrd _ No.of Meters 1 New Service 150 Amps 120 / 240 Volts Overhead x Undgrd _ No.of Meters 1 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of 39 roof mounted solar panels- 15 KW- No ESS SMART MFTFR Completion of the following table may be waived by the Inspector of Wires. No.of Total t..b No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- 1Vo.of Emergency Lighting k No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones oNo.of Switches No.of Gas Burners No. Initiatingon nDete and Devices Ili No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW 'No.of Self-Contained p° Totals: Detection/Alerti g Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ other Connection No.of Dryers Heating Appliances KW SecN o Systems:* f Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications el No. f Devices oor Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 4,026.67 (When required by municipal policy.) Work to Start:0$/01/2022 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 0 BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Summit Energy Ja-m-ey Pre-co-Lw(- LIC.NO.: 4310 Al Licensee: James Precourt Signatureja, vn,e,4, pre p-iA-rt- LIC.NO.:12418 A (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:339-201-7769 Address: 293 1 ihbey Industrial PKWY #250 Weymouth.MA 02189 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ g , The Commonwealth of Massachusetts Department of Industrial Accidents 2 Office of Investigations (5, Lafayette City Center — ' 2 Avenue de Lafayette, Boston,MA 02111-1750 , www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):Summit Energy Group Address:293 Libbey Industrial Pkwy, Unit 250 City/State/Zip:Weymouth, MA 02189 Phone#:339-201-7769 Are you an employer? Check the appropriate box: Type of project(required): 1.❑■ I am a employer with 10 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152,§1(4),and we have no employees. [No workers' 13.®Other Solar comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Colony Insurance Company Policy#or Self-ins. Lic.#: 001120909 Expiration Date: 11-03-2022 Job Site Address: 23 Harbor Hill Run City/State/Zip:Yarmouth, MA 02664 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature:�--�-., Z� Date: 07/18/2022 Phone#: 339-201-7769 ✓✓✓ Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(check one): 11:3Board of Health 2❑Building Department 3,12City/Town Clerk 4.0 Electrical Inspector 5Eilumbing Inspector 6.0Other Contact Person: Phone#: