HomeMy WebLinkAboutBLDE-22-006008 Commonwealth of Official Use Only
Massachusetts •
Permit No. BLDE-22-006008
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:4/20/2022
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) 14 BROOKHILL LN
Owner or Tenant PAPADONIS JOHN N Telephone No.
Owner's Address 14 BROOKHILL LANE, 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 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(14 Panels 5.04 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
rnd. 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. To
No.of Alerting Devices
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 0 Municipal ❑ 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 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: VS SUB I, LLC
Licensee: John Rodrigue Signature LIC.NO.: 100073
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 198 Ayer Road, Harvard MA 01451 Alt.Tel.No.: 8562421295
*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) ❑ owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$150.00
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RECEIVED
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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: 4/11/22
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) 14 Brookhill Lane
Owner or Tenant John Papadonis Telephone No. 856 242 1295
Owner's Address 14 Brookhill Lane Yarmouth,MA 02673
Is this permit in conjunction with a building permit? Yes Ej No ❑ (Check Appropriate Box)
Purpose of Building Residential Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Undgrd❑ 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: Installation of 14 roof mount solar panels-5.04KWDC Photovoltaic System
ko
�' Completion of the followin&table nt91 be waived by the Inspector of Wires.
- No.of Recessed Luminaires No.of Cell.-Snap.(Paddle)Fans No.of Total
Transformers KVA
ck
No.of Luminaire Outlets No.of Hot Tubs Generators ICVA
Pool Above In- No.of emergency Lighting
No.of Luminaires Swimminggrad. ❑ grad. ❑ 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 Total
g No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number ITons KW No.of Self-Contained
Totals: ."" I Detection/AlertingDevices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal
Connection ❑ Other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of No.of Devices or Equivalent
No.of
Heaters ' Signs Ballasts Data Wiring:
No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equiv eat
OTHER: Solar
Attach additional detail if desired or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 8000 (When required by municipal policy.)
Work to Start: 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 0 OTHER 0 (Specify:)
I certify,under the pains and penalties ofperjury,that the information on this application is true and complete.
FIRM NAME: VS Sub I, LLC
Licensee: John Rodrigue ktip
LIC.NO.: 100073MR
enter "in the Signature • B LIC.NO.: 8108
Address:
bre 198 Ayer Road,/Harvard,icense MA ne.01451
us.TeL No.: 856 335 2249
*Per M.G.L.c. 147,s.57-61,security work requires Al'.Tel.No.:
OWNER'S INSURANCE WAIVER: I am aware that the Department
not havethe liability insurance coverage n�y`
required by law. By my signature below,I hereby waive this requirement. I am the(check one 0 owner owner's a ent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$