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Home My WebLink AboutBLDE-21-007198 l'� °v Commonwealth of Official Use Only IN Permit No. BLDE-21-007198 • 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:6/10/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 52 CAPT CHASE RD Owner or Tenant MISKINIS JOHN P Telephone No. Owner's Address MISKINIS M JANE,52 CAPT CHASE RD,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 (12 Panels 3.9 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- ElNo.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/Alertine 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 Data Wiring: Heaters Siens 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: (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 signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PE T FEE:$150.00 ammonraea/h n/MadeiawL,344 Official Use Only ), ., i cc�� Permit No. Z"(—7 /f_ 2) cc77epartnwnl o�.tir e servicesi 1 i '' 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),52 CMR 12. (PLEASE PRINT IN INK OR E ALL INFORMA N Date: 2_ i City or Town of: aml o�� To the Inspector of Tres: By this application the undersigned yes notice of his or her mien n to perform the elec 'cal work described below. Location(Street&Number Owner or Tenant Telephone No. Owner's Address . .k. Is this permit in conjunction with a building permit? Yes a No ❑ (Check Appropriate Box) Purpose of Building (A tVle I I ( SUtility Authorization No. Existing Service IOU Amps Ilet/2*-1(N)olts Overhead❑ Undgrd❑ No.of Meters ' New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �� ( , 'Z Vo IA our t— Otai✓ c,NI, s) 3 . 9 + :-w Completion of the followintable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans T Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pow Above ❑ In- ❑ No.of Emergency Lighting grad. grad. 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. Ton No.of Alerting Devices 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❑ Monneunicipalction ❑ other C No.of Dryers Heating Appliances KW Security Systems:* No.of 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 Wiring: No.of Devices or Equivalent OTHER: D(�(�,{ C Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of 1 1 Work: (j� , (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COS E: 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 0 (Specify:) I certify,under penalties f 'my, dte information n this p ' ' n is true and complete FIRM NAME: lr LIC. Licensee: L'(]�f&t P . t\ Signature .NO.: t c(c) fN (If applicabl enter' em r pt"in the lie a number litre. Bus.Tel.No.; 'y% Address: i1 Mt.Tel.No.: `i 1-1—C 5t O *Per M.G.L.c. 147,s.57 1,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 0 owner's agent. Owner/Agent I Signature Telephone No. I PERMIT FEE:$