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BLDE-22-000076
Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-000076 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:7/6/2021 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) 8 CANARY LN Owner or Tenant Henry Wafters Telephone No. / 0 e t, Owner's Address f J Is this permit in conjunction with a building permit? Yes 0 No 0 (Check ,�� s to V Purpose of Building Utility Authorization No. ? Z� Existing Service Amps Volts Overhead 0 Undgrd CINo.o 44 _ New Service Amps Volts Overhead 0 Undgrd ❑ No.of •ters/ dr.f Number of Feeders and Ampacity „.,4 Location and Nature of Proposed Electrical Work: Installation of solar PV system(15 Panels 4.875 KW) Completion of the following table may be waived by the Ins,: ' 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 ❑ Municipal ❑ 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 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. PERMIT FEE: $150.00 C ommonweaf h of MaMachuzetta Official Use Only* Permit No. (_ZZ' —t)01(/ P -0t .2epartmeret o/.ire Permit __r�= 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(M C).5 CM_7 12.00 ii (PLEASE PRINT IN INK OR TYKE ALL INFORt Ott) Date: I ., l . City or Town of: VO( To the Inspector o Wires: By this application the undersigned ives notice of his or her intention to perform the electrical work described below. Location(Street&Number) ' Cana.v'-'1 L U__r _ Owner or Tenant t\e nr i yebi i-c A j.c' Telephone No.la 3�� s'3(71 Owner's Address (/ 73 Is this permit in conjunction with a building permit? Yes Non (Check Appropriate Box) Purpose of Building .D �( I t Utili Authorization No. Existing Service I Amps 1 / 9 Vo s Overhead Undgrd _I No.of Meters I New Service Amps / Volts Overhead Undgrd No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: in5oU1 lot oc. rco a r photo oto tc cr SU }ins; , ;Lz I� t .,6 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 No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIR€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 AlertingDevices 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❑ iTunicipal ❑ 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 Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: /co Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value o Ele trica Work: �tJ (When required by municipal policy.) Work to Start: 1 2,.1 . Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C GE: 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 ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE gri BOND ❑ OTHER ❑ (Specify:) I certify,under tihf pains and penalties of'pet ry that the information on this ap 'cation is true and complete. FIRM NAME: V IV 11 Oa, , )- 1.C� L., LIC. NO.: Licensee: a Signature LIC.NO.: (If applicable. enter "exempt"in the license number,1,line.),_, �/',,, Bus.Tel.No.: 4' Address: OL{$� 14e,11 St 4 i Sr (U A �11t \ F ) Alt.Tel.No.:a ,--415 _i *Per M.G.L. c. 147,s.57-61,security work requires Depaituient 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/AgentPER PERMIT FEE: $ SignaturetuneTelephone No. Irrrr rvnn."'Ln(Irrv-L7-4 I na - O � g o co E CD z o Z F- .»m ,5 g U g�' Q Z Sm 2U4 0 U L ER. 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