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Home My WebLink AboutBLDE-22-000944 ry ��kk Commonwealth aof Official Use Only Massachusetts Permit No. BLDE-22-000944 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:8/18/2021 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) 154 CAPT SMALL RD Owner or Tenant Michael Medeiros Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check • I I ropriate Box) Purpose of Building Utility Authorization No. 0 II��.. Existing Service Amps Volts Overhead ❑ Undgrd 0 �, •rs New Service Amps Volts Overhead ❑ Undgrd N yi tfay Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of solar PV system. (20 Panels 6.8 KW • vv n Completion of the following table may 1 ector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of otal Transformers , •VA No.of Luminaire Outlets No.of Hot Tubs Generators + • /2 VA 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 on l 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 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 Eauivalent 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 R&O-Cre/t4 64424 L e�.l Z Commonwealth o`tt/ann..chu..sfl! L_Use Only Ig" -'/ (� Permit No. '/K%/ e.,t r-1 im " 2epartment`3're Jen/ice3 RI ice . , ' Occupancy and Fee Checked -'" pp I I t^ BOARD OF FIRE PREVENTION REGULATIONS [Rev.t/07] (leave blank) U _ 'z APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Q o All work to be performed in accordance with the Massachusetts Electrical Code 27 CMtR 2.00 LLI IX m( EASE PRINT IN INK OR A/ jNFO 0/Y) Date: IWir City or Town of: �l�l /��/ To the Inspector of Wires: By this application the undersi ' of hish to Perform the ark described below. Location(Street&Number) pt, r1(�JI I Owner or Tenant ti'4 IG A 1��i-' 1,.- 9' Telephone NZ-0pk 3 .Owner's Address . .rf% LQJ�"- A9'Q. Is this permit in conjunction with a building ''t? Yes R. No ❑ (Check Appropriate Box) d'Purpose of Building i ^�? yvy Utility Authorization No. Existing Service I(i Pi)1, j Amps l)/G-polts '0....&ad❑ Undgnig.t. No.of Meters New Service Amps / Volts Overhead❑ Uudgrd❑ No.of Meters Number of Feeders and Ampacity ^ Location and Nature of Proposed Electrical Work: (1 1 I / Ia_f rn0 Zia nits G. E Completion of the J l table may be waived by doe Ittsfieetor. Wires. No.of Total No.of Recessed Luminaires No.of CeiLSusp.(Paddle)Fans Transformers KVA No.of L.mlaaire Outlets No.of Hot Tubs Generators KVA No.a<Lnmie:Luminaires Swimming Pod Above ❑ In- No.01 Emergency Lighting grad. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Harmers No.of Detection and Initiating Devices g No.of RangesNo.of Air Co.d. Toot' No.of Alerting Devices No.of Waste DisposersHeat Pump Number Tons KW No.ofSelf-Contained Totals: .........._ - Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW I,ecai❑Municipal °dwr Connection Se rnri Systems:; No.of Dryers Heating Appliances Nouri yf Devices or Equivalent No.of Water Heaters KN, No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring No.of Devices or Equivalent OTHER r„I Attack additional detail ifdetbed or as required by the Inspector of Wires. `/ Estimated Value of leciricaalWork:I '� (Whet required by municipal policy.) Work to Stmtt%LI�% 1 Inspections to be requested in accordance with MEC Rule l0,and upon completion. INSURANCE CO ERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless f1 the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent The 3.1 undersigned certifies that such Ire is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND❑ OTHER 0 (Specify:) I certify,under ' ad of perjury,thhatAe.iajorsati on this application is true and complete. FIRM NAME: U� 111.S-ti it a I ►G(\ . + / . LIC.NO.: Licensee: SignatureLIC.NO (Ifapptic "exempt"in the lice Inea�.line.) Bus.Tell.No: t Address: Mx./I _ 1'el 1Sl'1 PAtifl MPI Ale.TeL No.: 141 ..— .Per M.C..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.B Owner/ Y my signature below,I hereby waive this requirement. 1 am the(check one ❑owner 0 owner's a ent Sig.atare Telephone No. PERMIT FEE:$ , t ( 3.) hr , $ M t - • - fin . .+. .. x . L3� � e - . .. . 3 at-1 .. - 6_ -'0 ''r j},'`F' • . S _ : • - . ;. [ _ • . t • . S . . . ' . ! . , ---