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HomeMy WebLinkAboutBLDE-21-005130 r of . " ► ('i') Commonwealth of Official Use Only fe.ni Massachusetts Permit No. BLDE-21-005130 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:3/11/2021 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) 2 HEADWATERS DR Owner or Tenant Audrey Clarke Telephone No. Owner's Address 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 El Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of solar PV system. (37 Panels 12.025 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 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 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 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 ifdesired,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 ❑ 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. PERMIT FEE: $150.00 Comnlenu/eank o/MaoSachusetis ¢Offiiciaal Use Only + __'t cc��rr�� Permit No. �[--C —s( 3 ■1- a 2)spartment o`�ire Services r=:'1 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 accordanceor with the Massachusetts Electrical Code(MF�,52 CMR 12 00 I (PLEASE PRINT IN INK OR L 1 1 OM v Date: J 3 �—, City or Town of: To the Inspector o Wires: By this application the undersigned Ives n tice of is r her intention to perform the electrical work described below. Location(Street&Number) ( �-s ) v� Owner or Tenant l J k re (A cut" , , Telephone No.3�-[-a --- Owner's Address a )e, d ,S a, ,A - Is this permit in conjunction with a b •ding permit? Yes ��No ❑ (Check Appropriate Box) Purpose of Building i , ( ` Utility Authorization No. Existing Service„ �ps 1�/ Z`-! ��is Overhead❑ Undgrd 0 No.of Meters I New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity p S Location and Natur f Proposed Electrical Work: ns t� l I ��un �—� - rx - rnuOnpho-roo c Q I(An s�"'�. � . 1 .cam s-- Completion of the following.tabie may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Tf Trr ano KVAsformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of I mergency Lighting grnd. grnd. Battery Units 8 , 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/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Monneunicictionp ❑ Other C No.of Dryers Heating Appliances No. Security Systems:* (� , No.of Devices or Equivalent v �J No.of Water No.of No.of KW Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent 13 No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent I rOTHER: C--r, Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lec cal Work „)-O (When required by municipal policy.) Work to Start: �� a Inspections to be requested in accordance with MEC Rule 10,and upon completion. U 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 o erage is in force,and has exhibited proof of same to the permit issuing office. '70_ CHECK ONE: INSURANCE,& BOND ❑ OTHER ❑ (Specify:) C I certify,under the pains and pe • of pe 'u ,that he informati° on is lication is true and complete. t--, FIRM NAME: 1 V .NO.: Licensee: U(" r) 1 m 1 L Signature (_____ .NO.: I�� Pi y (If applicable,enter exempt"in the license numb"lige,..� us.Tel.No.; �i ////���� rl Address: (owl S MV C7{1 S r ' �t Alt.Tel.No.. y 1.-- C5—:3 049 *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. 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