HomeMy WebLinkAboutMiscellaneous - 125 PEACH TREE LANE 4/30/2018 (26) `f ' t�nrnrrtotr!asa�ttr v�!// �ac�ruself� Official Use Only
Permit No.
- .aUePsrlmenE p�..tlrn Snrviaa.�
Occupancy and Fee Checked
BOARD OF EIRE PREVENTION REGULATIONS [Rev. 1/07] (Icave 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 INFORAM TION) Date:
City or Town of: NO)CM v &)d�) To the Inspec or•of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) I Q-S ka(. L-4g2L_
Owner or Tenant Lc f S T e n e n bq lam Telephone No. '"7 9) S -1 Z,G1�
Owner's Address
Is this permit in conjunction with a building permit? Yes ✓� No ® (Check Appropriate Box)
Purpose of Building, Residential Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Llndgrd❑ No.of Meters
New Service Amps ! Volts Overhead❑ tlndgrd❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: INSTALL.SOLAR ELECTRIC-PHOTOVOLTAIC(PV)SYSTEM
RATED 10 ,0, KW-DC @ S.T.C.GRID TIED.iN CONJUNCTION WiTH BUILDING PERMIT( �6 PANELS)
Cont letion of the follolrin !able nia,be ti,aived_bv the Ins ecta•o Wires.
= No.of Recessed Luminaires No.of Ceil.-Susp.(paddle)Fans �'.° ota
Transformers KVA
No.of_Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires _ Swimming Pottl ove El
n- El
o.o-Emergency Lighting
rad. rad. ll ante Units
No.of Receptacle Outlets No.of Oil Burners FiRE ALARMS No.of Zones
No.of Switches No.of Gas Burners o.o etectton a"d—
Initiating Devices
Tota
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers eat Pump umber Tons No.o c - ontainc T
p Totals: Detection/Alerting Devices
No.of Dishwashers Spacc/Area Heating KW Local❑ unmctpa ❑ Other
Convection
No.of Dryers Keating Appliances KW .ecurityvstems:
No.of devices or Equivalent
No.of Water Kw- o.o - oo 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 ifdesired,or as requir-ed ht,the Inspector of Wires.
Estimated Value of Electrical Work: t$T (When required by municipal policy.)
Work to Start:ASAP 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`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 Q BOND ❑ OTHER ❑ (Specify:)
I certify,under the paitms and penalties-of Ire6my,that the infor mation on this application is true and complete
FIRM NAME: SOLARCITY CORPORATION LIC.NO.:1 136M
Licensee: MATTHEW T. MARKHAM Signature LIC.NO.:1 136M
(If applicable,eater"exempt"in the license tinntber line.) Bus.Tet.1Vo.:rt4-2se sleo
Address' 24 ST MARTIN DRIVE(BUWING 2•UNIT 11)MARLBOROVOH,MA 017$2 Alt.Tel.No.•774.258-.8505
*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 hare the liability insurance coverage normally
required by taw. By my signature below,l hereby waive this requirement. 1 am the(check one)EEJ1owner ®owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE. S
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