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Home My WebLink AboutBLDE-22-000168 '' Commonwealth of Official Use Only ills Massachusetts Permit No. BLDE-22-000168 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.I/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:7/12/2021 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) 21 MERGANSER LN Owner or Tenant Stephany Kovar Telephone No. Owner's Address 21 MERGANSER LN,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Che u� Box) Purpose of Building Utility Authorization No Existing Service Amps Volts Overhead 0 Undgrd 0 o t New Service Amps Volts Overhead 0 Undgrd 0 M. 's b Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of solar PV system. (20 Panels 6.5 KW) // .;(*/( Completion of the following table may be w • e, s �y• ector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers O VA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In ❑ No,of Emergency Lighting g 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 No.of Waste Disposers Heat Pump Number Tons J KW No.of Self-Contained 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: LLOYD R SMITH Licensee: Lloyd R Smith Signature LIC.NO.: 15688 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 1ST ST, MELROSE MA 021764010 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$150.00 Ile- 10I zc (12-4 C , 5 Lem) Cmmonwea{th o`Mits:saciudetta Official Use Only /� = 2epartment o`gire Services Permit No. l,- 'r 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 C 12.00 (PLEASE PRINT IN INK OR TYPE INFORMA Date: (bJ 2s?t t City or Town of: V ryi ov��✓[�1 To the Inspector of Wires: By this application the undersigned s rtice()this or her intention to perform the eOctrical work described below. Location(Street&Number) Me gan SAX n Owner or Tenant Telephone No.T,3)E 11 Owner's Address V Is this permit in conjunction th a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Q" kLeit I I Utility Authorization No. (jam. Existing Service 1 Amps ie) /2 tVol Overhead ❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: I - — so la.( 1(23jIrnifInplelon 1 of the followingtable nw 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 mod• grnd. Battery Units • No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump Number I Tons 1KW No.of Self-Contained Totals: I' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent � ' T �b Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: U (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RA E: nless 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 cpyrage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I cerpi ,under pe fy:) IY pains and, , ofperJury,that the•nforination on this app` , n is true and complete. FIRM NAME:V A _ ILO A Licensee: V _ LIC.NO.: g h 0, Signature � I VIIIIIIIII ..NO.: �� f)-- af applicabig 'exempt": the lie, =number Cried �� _ Address: C L te,� u ,A 0 ` - Bus.Tel.No.- G� *Per M.G.L.c. 147,s.57-6 ,securitywork '•'� �e Alt.Tel.No.: L`jl OWNER'S INSURANCE WAIVR: I am aware thatLicensee doof es not have the liac Safety"S" bility Lin.No. required by law. By my signature below,I hereby waive this requirement. I am the(check one ownerrance • wnner'sa ll nt Owner/Agent Signature Telephone No. PERMIT FEE:$