HomeMy WebLinkAboutBLDE-23-001907 Commonwealth of Official Use Only
4. Massachusetts Permit No. BLDE-23-001907
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:10/11/2022
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) 32 LINCOLN AVE ,_
Owner or Tenant DOUGLAS ELDRIDGE Telephone No.
Owner's Address 32 LINCOLN AVE,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 (25 Panels 9.125 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
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 ❑ 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 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: 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
RECEIVE
i T 1 1 2022 C ,nwea/h o`�rlassacl u Setts Official Use Ong
'— 1 Permit No. fl 1
3F-r— t 746 e artment o ire Servicee4 . NG DEPARTMENT P Occupancy and Fee Checked
rl 1_— :"4 -E 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 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 10/01 I a a
0 City or Town of: y o r ryl p f-k-tel To the Inspector of Wires:
L./ By this application the undersigned Kives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 3 o[ Li r-Sr '_t k f\(�,
Owner or Tenant CV ` ' irOS ��r r^j(i v.. Telephone No. i-ILl(6 (Nal
L- Owner's Address 5(1 neJt. 05) a e
5 Is this permit in conjunction with a building permit? Yes 71 No ❑ (Check Appropriate Box)
,) Purpose of Building Utility Authorization No.
lam) Existing Service ‘0 Ci. Amps 11,6/ a,C}Q Volts Overhead TO Undgrd n No.of Meters
V New Service Amps / Volts Overhead Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
C Location and Nature of Proposed Electrical Work: •I yvv aktoc ►0, o - an -InAerconnt f
roO-e to la 'Pil S a.6 pc o1 q .I a. e \IntiJ
Completion of the following table may be waived by the Inspector of Wires.
otal
No.of Recessed Luminaires No.of Ceil:Sus (Paddle)Fans No.ofTVA
P• Transformers KVA
E No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Above In- No.of Emergency Lighting
No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units
0 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
2 No.of Ranges No.of Air Cond. Total
Tons No.of Alerting Devices
No.of Waste Dis posers Heat Pump Number Tons KW No.of Self-Contained
P Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ Other
J P Connection
0 No.of Dryers Heating Appliances KW Security Systems:*
nNo.of Devices or Equivalent
Y` No.of Water KW No.of No.of Data Wiring:
+ Heaters Signs Ballasts No.of Devices or Equivalent
E No.H dromassa a Bathtubs No.of Motors Total HP Tel Nommueviceso orsWiring:q al
y g No.of Devices Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: la 14 5 6,c (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
8 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 ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
N FIRM NAME: Sunrun Installation Services j� LIC.NO.:4316 Al
d Licensee: Nathan Ashe Signature f�X-�tf�-' LIC.NO.:21136A
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.1978-594-3519
Address: 695 Myles Standish BLVD Taunton MA 02780 Alt.Tel.No.:
0-- *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)❑owner ❑owner's agent.
Owner/Agent PERMIT FEE: $
Signature Telephone No.
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