BLDE-22-006484 Commonwealth of Official Use Only
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E-L.4 Massachusetts
Permit No. BLDE-22-006484
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:5/11/2022
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) 8 ORCHID LN
Owner or Tenant MCCARTHY JEFFREY T Telephone No.
Owner's Address MCCARTHY LAURA C, 8 ORCHID 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(27 panels 9.18 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
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 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 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: Nathan A Ashe
Licensee: Nathan A Ashe Signature LIC.NO.: 21136
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 166 Hunt Rd, Chelmsford MA 018243747 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
,M1 V2jg/ '
Commonwealth o///Jasaachudello al Use Only Lt
1 6 c� Permit No. �`E' t o 1
w `Ml+ 11 Jleuartmenl o/ ire Serviced
f V- F5 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
1-.` [Rev. I/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: 5-u •(�,((}!
City or Town of: Yormith To the Inspector of Wires:
By this application the undersigned gives notice of for her intention to perform the electrical work described below.
Location(Street&Num er) 2 /rch a `n
Owner or Tenant ) t l od Telephone No. 77y-3 3 -�'ni
Owner's Address 8 r Q k f pp
V
Is this permit in conjunction with a building permit? Yes ta No ❑ (Check Appropriate Box)
Purpose of Building t---)[,t try . Utili Authorization No.
Existing Service if Amps /0110 Volts Overhead Undgrd❑ No.of Meters I
New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
Number of Feeders and Ampacity �(
Locatioonand Nature of Proposed Electrical Work: 1ns-0I 10-10 f�: red mC-
p,* _UOthnic SO[Or s $temps ; a7 pe reis 94 KI3
Completion of the following table may be waived by the Inspector of Wires.
No.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVAVA
No.of Luminaire Outlets No.of Hot Tubs Generators ICVA
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 Alerting No.of 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 Valu of 'cal Work: It i I ,Nj (When required by municipal policy.)
Work to Start: ,., Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGEi 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 a is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify:)
I certify, under t p 'ns andpen hies of perjury,that the information on this application is true and complete.FIRM NAME: LIC.NO.:91 3cA
Licensee: ; Signature LIC.NO.:
(If applicable nter" empt"i t e lic nse number 1, e.).
A fi �,t,✓� q Bus.Tel.No.:
Address: Cy5• ryes _ ' 'Sh le/ j I (JfWC1/7 t l !1/ , ( 7O Alt.Tel.No.:
*Per M.G.L.c. 147,'s)57-61,security work requires Department 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)0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $
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