BLDE-22-000830 ckV Commonwealth of Official Use Only
ilPti. Massachusetts Permit No. BLDE-22-000830
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:8/13/2021
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) 6 NANCY WAY
Owner or Tenant GAUNTLETT JOAN M TR Telephone No.
Owner's Address JOAN M GAUNTLETT LVG TRUST, 1598 MARINA WAY, NANOOSE BAY, BC V9P 9B5
Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters
New Service 125 Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: nstallation of solar PV system&service upgrade. (19 Panels 6.650 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- ElNo.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
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 ❑ 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 Signs 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 ❑ 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: Matthew T Markham
Licensee: Matthew T Markham Signature LIC.NO.: 1136
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:24 SAINT MARTIN DR,BLDG 2 UNIT 11,MARLBOROUGH MA 017523060 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
No y - ucasi 7/771,4 (ftcRz-c--
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commonwealth oQ /
cc�� l��77dache Official Use Only
0 2lepartment o/.}ire Serviced
�i_ Permit No. 22� d j 3
�`'r` BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[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: 08/11/2021
City or Town of: Yarmouth
To e 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)6 Nancy Way
Owner or Tenant Joan Gauntlett
Telephone No. 774-368-6603
Owner's Address 6 Nancy Way,West Yarmouth,MA 02673
Is this permit in conjunction with a building permit? Yes
il Purpose of Building Residential NO ❑ (Check Appropriate Box)
Utility Authorization No.
Existing Service 125 Amps 120 / 120 Volts Overhead
❑ Undgrd❑ No.of Meters 1
New Service 125 Amps 120 / 120 Volts Overhead
•Number of Feeders and Ampacit ❑ Undgrd Ell No.of Meters 1
Location and Nature of Proposed Electrical Work: roof mounted pv solar panels-6.650Kw system-19 total panels-125A
Com p letion o the ollowin•table ma be waived b the Ins.-ctor o Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of
Transformers Total
KVA
No.of Luminaire Outlets No.of Hot Tubs
Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- O.o mergency ig mg
No.of Receptacle Outlets .rnd. rnd. ❑ Batte Units
No.of Oil Burners i FIRE ALARMS No.of Zones 1 No.of Switches No.of Gas Burners No.o Detection and
No.of Ranges Initiatin Devices
No.of Air Cond. Total
Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.
Totals: of Self- ontained
No.of Dishwashers Detection/Alertin. Devices
Space/Area Heating KW Lhil❑ Municipal
No.of DryersHeating Connection ❑ Other
eating Appliances KWSecurity Systems:* —'
No.of Water No.of No.of Devices or E.uivalent
Heaters KWNo.of Data Wiring:Sins Ballasts
No. Hydromassage Bathtubs No.of Devices or E r uivalent
No.of Motors Total HP Telecommunications Wiring:
o.ofOTHER:roof mounted pv solar panels- 6.650Kw system- 19 total panels-125AeV1ces •or E uivalent
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 22663.20
Work to Start:u on a (When required by municipal policy.)
p pprovals 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 operation"
coverage or its su
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuingtofficeuivalent. The
CHECK ONE: INSURANCE 0 BOND ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Freedom Forever Massachusetts LLC
LIC.NO.:MA 902-EL-Al
Licensee: Matthew Markham �^
(If applicable,enter "exempt"in the license number line) Signature LIC.NO.:1136 MR
Address: 135 Robert Treat Paine Dr,Taunton,MA,02780
Bus.Tel.No.:Alt.Tel.No.:______________*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
Alt.Tel.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/Agent
Signature El owner's a_ent.
Telephone No. PERMIT FEE: $
'17 (F32.0-55-3 l