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HomeMy WebLinkAboutBLDE-22-000304 Commonwealth of Official Use Only 41. ;, Massachusetts Permit No. BLDE-22-000304 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:7/19/2021 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) 106 CAPT YORK RD ✓' Owner or Tenant Joyce McFarland Telephone No. 0 g Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check . o o •o p i 4;3 Purpose of Building Utility Authorization No. 4.1' Existing Service Amps Volts Overhead 0 Undgrd 0 No.o a a New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters rdp ir f p, • Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of solar PV system.(27 Panels 9.04 KW) 4',,4 io Completion of the following table may be waived by the Inspe . o_f 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. gtrnd. 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 Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: SOLAR WOLF ENERGY Licensee: Kyle Zuidema Signature LIC.NO.: 22593 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 771 Washington Street,Auburn MA 01501 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 ID S (Le-0 m Official Use Only Conurtonw�a of ��/aeeac —a��y pa n � Permit No.C:-2, 4_ ' �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 hi accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 o (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7/1/21 City or Town of: South Yarmouth, MA 02664 To the Inspector of Wires: rnBy this application the undersigned gives notice of his or her intention to perform the electrical work described below. a) Location(Street&Number) 106 Captain York Road Owner or Tenant Joyce McFarland Telephone No.(508)934-9288 l Owner's Address 106 Captain York Road South Yarmouth. MA 02664 / ctj Is this permit in conjunction with a building permit? Yes ® No 0 (Check Appropriate Box) j/ rn Purpose of Building Residential Utility Authorization No. .19 Existing Service 100 Amps 120 / 240 Volts Overhead ►: Undgrd 0 No.of Meters 1 cp New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters a)-. Number of Feeders and Ampacity p 1 Location and Nature of Proposed Electrical Work: Installation of 9.04kW grid tied roof mounted solar system using 27 SunPower c, 335W AC panels with built-in microinverters.Installation of empty meter socket for SMART generation meter. VI Completion of the followinktable nray be waived by the Inspector of Wires. vt No.of Total q'F No.of Recessed Luminaires No.of Cell.-Snap.(Paddle)Fansoi Transformers KVA C-I, Generators KVA No.of Luminaire Outlets No.of Hot Tubs teen of Emergency Lighting +^ Above In- rg cY g No.of Luminaires Swimming Pool grad. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Detection and . - No.of Switches No.of Gas Burners Initiating Devices t<f No.of Ranges No.of Air Cond. Toffi No.of Alerting Devices Heat Pump I Number.I Tons 1KW.___. No.of Self-Contained No.of Waste Disposers Totals: Detection/Akrtin�Devicea M No.of Dishwashers Space/Area Heating KW Local 0 Connectionunicipal 0 Mier No.of Dryers Healing Appliances Security Systems:*KW No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent Telecommunications WirIng No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: $13,188 (When required by municipal policy.) completion. Work to Start:09/01/21 Inspections to be requested in accordance with MEC Rule 10,and upon co mp INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND 0 O El (Specify:)on application is true and complete. I cei7ljy,under the pains and penalties ofpe ' LIC.NO.: e. #186400 FIRM NAME: Solar Wolf Energy � / Signature G/+' LIC.NO.: 22593 A Licensee: Kyle Zuidema Tel.No.;(508)t339 2222 (If applicable,enter"exempt"in the license number line.) Bus.. No.: Address: 771 Washington St Auburn,MA 01501 t Public Safety"S"License: Tel..No. normally *Per M.G.L.c. 147,s.57-61,security work requires Departmen OWNER'S INSURANCE WAIVER: I am aware that the Licensee does notes�ns ownerurance coverage❑owner's a required by law. By my signature below,I hereby waive this requirement. gent Owner/Agent -felephone No. 'PERMIT FEE:$ Signature A`� ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/09/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Corby Schilling Leonard Insurance Agency,Inc PHONE (508)428-6921 FAX (A/C.No.Ext): (A/C,No): (508)420-5406 683 Main Street E-MAIL ADDRESS: Corby@leonardagency.com Suite B INSURER(S)AFFORDING COVERAGE NAIC# Osterville MA 02655 INSURER A: Main Street America Group(AKA NGM Insurance 14788 INSURED INSURER B: Richard Sahl INSURER C: DBA:Richard Sahl,Electrician INSURER D: 351 Monomoscoy Road INSURER E: Mashpee MA 02649 INSURER F: COVERAGES CERTIFICATE NUMBER: 23-24 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD VI/VD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE n OCCUR DAMAGE TO RENTED 500,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 A MPT6401V 01/27/2023 01/27/2024 PERSONAL BADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- JECT I J LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE ._ AUTOS ONLY _ AUTOS ONLY (Per accident) $ $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER 0TH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Electrician in MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS. 1146 Route 28 AUTHORIZED REPRESENTATIVE South Yarmouth MA 02664 r„( I .� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD