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HomeMy WebLinkAboutBLDE-22-005095 a a\itA Commonwealth of Official Use Only SE-- '' Massachusetts Permit No. BLDE-22-005095 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:3/15/2022 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) 49 ADAMS RD Owner or Tenant MCGOVERN MICHAEL R Telephone No. Owner's Address 49 ADAMS RD, WEST YARMOUTH, MA 02673 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 ❑ 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(20 Panels 6.5 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 Initiatine 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 ❑ 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 Siens No.of Devices or Euuivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Euuivalent 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 Licensee: Nathan A Ashe Signature LIC.NO.: 21136 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 166 Hunt Rd, Chelmsford MA 018243747 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 Y ( % (9)'-t(2CPL & Rt±-1)) - — Commonwealth o�///as�ac�zuaella Official Use Only ,, _ 2Z 5 wP- 't c� �7 Permit No. t71, 2)epartmenl o/.}ire Serviced Occupancy and Fee Checked ,t 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: 3-Q - ` Q9 City or Town of: V3 r mall h To the Inspector of Wires: By this application the undersigned give notice of his oro er intention to perform the electrical work described below. Location(Street&Number) Li q give k urn �[Owner or Tenant od1U eA Mt e Telephone No.l�2-' -82C 3 Owner's Address or ��U V Is this permit in conjunction with a building permit? Yes 4' i No ❑ (Check Appropriate Box) Purpose of Building nio tti Utility Authorization No. Existing Service Amps / I� Volts Overhead E/ UndgrdNo.of AC L"J g El Meters New Service Amps / Volts Overhead El Undgrd El No.of Meters Number of Feeders and Ampacity Locationand Nature of Proposed Electrical Work: Ins 13— ( n ,1 ()fowled7hd tin ic -i[ g , Kc 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 Tot 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 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal 0 Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of Heaters KW Data Wiring: 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 Valu of cal Work: (When required by municipal policy.) Work to Start: ` A` 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 cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [ BOND ❑ OTHER 0 (Specify:) I certify,under t p 'ns and pen ties of perjury,that the information on this application is true and complet . FIRM NAME: LIC.NO.: Licensee: Signature LIC.NO.: (If applicable nter e empt"i t �e license nu ber lyze.,L. l $`j.,t� r (f Address:applicable., " 5.mks a C'�/1G7i_ IS/i / 1 iU(,Jfl .1i7 t Mg , MVO Alt.Tel.No.: Bus.Tel.No.: *Per M.G.L.c. 147,s157-61,security work requires Department of Public Safety o. 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ I