HomeMy WebLinkAboutBLDE-23-001288 Official Use Only
Commonwealth of
. V Permit No. BLDE-23-001288
'� Massachusetts
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:9/12/2022
To the Inspector of Wires:
City or Town of: YARMOUTH
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 23 POINSETTIA DR
Owner or Tenant LINDSAY GUINON Telephone No.
Owner's Address 23 POINSETTIA DR,SOUTH YARMOUTH, MA 02664
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(13 Panels 4.615 KW DC)
Completion of the following table may be waived by the Inspector of Wires.
No.of Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA
No.of Luminaire Outlets
No.of Hot Tubs Generators KVA
Above In- ❑ No.of Emergency Lighting
No.of Luminaires Swimming Pool grnd. ❑ grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones
No.of Detection and
No.of Switches No.of Gas Burners Initiatinc Devices
No.of Air Cond. Total No.of Alerting Devices
No.of Ranges Tons
Heat Pump . I Number I Tons I KW No.of Self-Contained
No.of Waste Disposers Totals: Detection/Alertine Devices
Local ❑ Municipal 0 Other:
No.of Dishwashers Space/Area Heating KW Connection
Security Systems:*
No.of Dryers Heating Appliances KW No.of Devices or No.
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Siens No.of Devices or Equivalent
Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP 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 LIC.NO.: 21136
Licensee: Nathan A Ashe Signature
Bus.Tel.No.:
(If applicable,enter"exempt"in the license number line.) Alt.Tel.No.:
o.
Address: 166 Hunt Rd, Chelmsford MA 018243747
*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 I PERMIT FEE: $1 SD.00 I
Signature Telephone No.
c!),W
1Q/44 ef
RECEIVED
SEP o r�`= C nh / l Official Use Only
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t S- I Permit No. C..i21 . k 26 6
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BUILDING Dk.� NIT Occupancy and Fee Checked
M.IIj�
By _______ ,�=— BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07
. � j (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical ode MEC),52 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL FORMATION) Date: • �-goa
City or Town of: VarrYOUth To the Inspector of Wires:
By this application the undersigned g' es notice o is or her'ntention to perform the electrical work described below.
Location(Street&Numbe ) is
1( n
Owner or Tenant Li Telephone No. 00 fft J p[7
Owner's Address Same as Ab e
Is this permit in conjunction with a building permit? Yes ® No n (Check Appropriate Box)
Purpose of Building Residential Utility Authorization No.
Existing Service Amps 120 /240 Volts Overhead❑ Undgrd❑ No.of Meters 1
New Service Amps / Volts Overhead n Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Installation of an interconnected Roof Mounted PV system
(3 Panels,4.115 KwDC.
Completion of the following table may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf
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
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 ❑ Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water Kam, No.of No.of Data Wiring:
Heaters Signs 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: ga 1C 60 (When required by municipal policy.)
Work to Start:ASAP 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 ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on his application is true and complete.
FIRM NAME: Sunrun Installation Services LIC.NO.:4316 Al
Licensee: Nathan Ashe Signature LIC.NO.:21136A
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:978-594-3519
Address: 695 Myles Standish BLVD Taunton MA 02780 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 [PERMIT FEE: $
Signature Telephone No. ��nn
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