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Home My WebLink AboutBLDE-19-000507 ✓ Commonwealth of Official Use Only dna EE..�f� Massachusetts Permit No. BLDE-19-000507 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.1/071 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:7/25/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 134 WATER ST Owner or Tenant STAUDENMAYER MARY ANN S TR Telephone No. Owner's Address M A S STAUDENMAYER REV TRUST, 134 WATER ST,YARMOUTH PORT,MA 02664 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 ❑ Undgrd ❑ No.of Meters New Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install generator. 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 1 KVA 11 No.of Luminaires Swimming Pool Above ❑ 14 - ❑ 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 0 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 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: WAYNE B SCHMIDT Licensee: Wayne B Schmidt Signature LIC.NO.: 33699 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:222 WILLIMANTIC DR,MARSTONS MLS MA 026481929 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,secunty 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 signature below,I hereby waive this requirement.I am the(check one) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 9(130 8 Iree CRC*9_I`f • Conanonmeat'Us of/r(assaehrurfl! Official Use Only l'Ot riP - t JJeragnwel ei�yirr Services Permit No. Occ°PanaS and'see Checked ... - ,. - ,i BOARD OF AREPREVENTION REGULATIONS [Rev. I/07J - (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical (PLEASE PRINT IN INK OR �tINFORM() Date: f 1 it r City or Town of: MO INFORM() Ls�\ To the Inspector of Wires: By this application the undersign „veea.,,notice of h• or er in - tion toperform the electri.: work described below. • Location(Street&Number) 11, -' S t J ^--rd OwneforTenant W ` \ \ V\--0v' • fY\My P.r Telephone No3c7- ( /6a�J 3 Owner's Address -' Is this permit in conJu ion with a h\tri ding permit? Yes 0 No (Check Appropriate Box) Purpose of Building l fJ r1\\ `r o Utility Au minden No. Existing Service Amps • / is Overhead 0 Undgrd 0 No.of Meters • New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters • Number of Feeders and Ampacitya Location nd Nat roposed ctrical Work,: A - I Completion of the followin table omay be waived by the Inspeci rof From NNo.of Recessed Luminaires No.of CeiLSusp.(Paddle)Fans Totalf • KVA No.of Luminaire Outlets No.of Hot Tubs KVA 41 • No.of Ldminalres Swimming • Pool Above Q In-- :ency Lighting 1 . grad.. grad. Battery Units • No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detettion and Initiating Devices No.of Ranges No.of Air Cond. .Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons ICW No.of Self-Contained - Totals: . Detection/Atetiingpeyices No.of Dishwashers Space/Ara Heating ICW Local Coeetio n ❑ Other No.of Dryers Heating Appliances Security Systems:' No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: • Heaters Signs Ballasts g No.of Devices or Equivalent No.Hydromassage Bathtubso No.of Motors Total H P Telecommunications Wiring: \ / No. evicts Equivalent OTHER: -- UD\/ Y, ` p„,.\\,,ip„,.\\,, W)1 1'`QM Attach additional detail if desired or as required by t Inspector of Wires. Estimated Va f ec • Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE E: 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 0 (Specify:) I cattfy,ur the information on this application is true and complete.• n o rn FIRM NM WAYNE SCHMIDT LIC-NO.:e ELECTRICIAN Licenser. 222�NILLtMANTIC DRIVE Signature LIC.NO.: MARSTONS0MILLS,MA 02648 (lfrNplrcabl ((508)428-7747 . Bus.Tel.No.• 7,3/7 217) Address: • • Alt.Tel.No.. "Per M.G.L.c. 197,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 hove 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/AgentPERMIT FEE: $ C��' SignaturetureTelephone No.