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Home My WebLink AboutBLD-21-007445 �' � Commonwealth of Official Use Only -111�\ Massachusetts Permit No. BLDE-21-007445 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:6/22/2021 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) 11 CAPT SIMMONS RD Owner or Tenant David Rhodes Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Checkp o C B x) Purpose of Building Utility Authorization No. /^ v Existing Service Amps Volts Overhead 0 Undgrd 0 ' ' 7'b ' %' New Service Amps Volts Overhead 0 Undgrd 0 f/] g rr� Number of Feeders and Ampacity t Location and Nature of Proposed Electrical Work: Installation of solar PV system(11 Panels 3.5 KW) o �' CompletionVV •` �j ofthe following table may be waive �, •ctor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of ` al Transformers 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 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 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 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 ❑ (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 commonwealth o/Maddachudettd Official Use Only c,, _ .-1lepartment o�.}ire-Serviced Permit No. l L4e rf t 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).527 R 12. 0 (PLEASE PRINT IN INK OR TYPE LL INFORMAMDate: I ( �Z- City or Town of: Ckl Y To the Inspector of res: By this application the undersigned giv s notice of his or her intention to perform the electrical work escri ed below. Location(Street&Number) S ' rY-' Owner or Tenant akkr i , Cs' Telephone No. t ''72-1 4 Owner's Address c' a2�0 _ Is this permit in conjunctiaa with a building permit? Yes n No ❑ (Check Appropriate Box) Purpose of Building �� , 1 (A Utility Authorization No. Existing Service Il(> Amps 12O /9140 Vo1Ts' Overhead Undgrd❑ No.of Meters _ I New Service Amps / Volts Overhead I ( Undgrd No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: lnv n of pho ovcibate is r sts rs, . I°l S 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 Abe ❑ In- ❑ l o.of Emergency Lighting 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 LS No.of Ranges No.of Air Cond. TonsTotal 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 Connection El Other 61 . --:- No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent of Motors Total HP Telecommunications Wiring: No.Hydromassage Bathtubs No. No.of Devices or Equivalent OTHER: ,)C0 Attach additional detail f desired,or as required by the Inspector of Wires. Estimated Value o Elec ical Work: j( (When required by municipal policy.) Work to Start: Z ( Inspections to be requested in accordance with MEC Rule 10,and upon completion. \3 INSURANCE CO E 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 I+� BOND ❑ OTHER ❑ (Specify:) I certify,under t hi.pains and penalties of'per' ry,that the information on this ap cation is true and complete. FIRM NAME: (�� C. ,V � �� {p. LIC.NO.: Licensee: L..., a ��(5 T 1OP•N Signature b ____O LIC.NO.: (If applicable. enter "ecempt"in the license number l ine.) '� Address: MTMt\,1IIJi S->'{�M i kh (3 It r —moon t? 1 �� Bus.Tel. No.: --(r *Per M.G.L.c.'147,s. 57-61,security work requires Department of Public Safety"S"License: Alt.Lic.No. 3 �� 1 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally C required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. rOwner/Agent I Signature Telephone No. I PERMIT FEE:$