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Home My WebLink AboutBLDE-19-000839 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-000839 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.l/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:8/13/2018 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) 13 MACKENZIE RD Owner or Tenant BRYSON NANCY E Telephone No. Owner's Address COLINA JORGE J, 13 MACKENZIE RD,SOUTH YARMOUTH, MA 02664 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 ❑ 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: A/C system Completion of the followmg 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 11AbovIn e ❑ - 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. 1 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 ❑ 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 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 ❑ OTHER 0 (Specify:) /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 Mt.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 signature below,I hereby waive this requirement.I am the(check one) 0 owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 C9tk ei (ti /r{ �- ga ci<G. - . ----.--422,V± . • S 's tilal' / /lnasai� 3laf! _ i, a Permit No.xpeolaun(of. ire Jarricv!9 . IQ- _ (kcupancy andFee Checked ' ° t BOARD OF ARE PREVENTION REGULATIONS (Rev.I/o7) (leave blank) • APPLICATION FOR PERMIT TO PERFORM E ECTRICAL WORK All work to be performed in aceadente with the Massachusetts Electrical Cype f271C7�12.00 (PLEASE PRINT IN INK OR I' AL IjV�O9[(11;p3F0]i7 Date: NO �0/ City or Town of: (U�� To the Inspector of Wires: . By this application the undersi a sa.,yes notice of his or her intention to perform the el etrical work degibFd below. • Location(Street&Number) ur., M 41 V. �!L L )"+ 41► Owner•orTenant -"tit,L _ . , Telephone No. • V 14 et Owner's Address nip - Is this permit in conjunction with a b ilding permit? Yes 0 No (Check Appropriate Box) Purpose of Building f� \.\f Utility�ortritlon No.. • Existing Service •__ Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 Ne.of Meters Number of Feeders and Ampacity Location and store of Proposed Electrical Work: (l , ' r\,p , 1A q �c_ _ • v�j ` tl/ I1/v1 • Completion ofthefollowin table ...� g moy be waived by the frtsppeeccttoro/{Prru. No.of Recessed Luminaires No.of CeB Snap (Piddle)Fans No.of Total Transformers KVA No,of Luminaire Outlets No.of Hot Tubs Generators KVA , • No.of Ldminaires - • ' Swimming Pool grad.. graAbove ❑ In-d. ❑ BatNo.toefry LmergencyUnits Lighting No.of Receptacle Outlets No.of Oil Bunters FIRE ALARMS No.of Zones� No.of Switches No.of Gas BuNo.of Deteatton and Initiating Devices No.of Ranges No.of Air Cond. .Tonal No.of Alerting Devices No,of Waste DisposersHeat Pump Number Tons 1.'W No.of Self-Contained �� Totals: Detection/Alerting Devices . •No.of Dishwashers Space/Area Heating KW Local❑CoMannnectioietpaln "0 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 No.of Devices or Equivalent • No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent ER: .k--- Ulm t �rr \1(�(A Attach additional detail if desired or as required by the Inspector of Wires. timat Valu or El al Work: (When required by municipal policy.) Work to Start: 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 co erage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) I cent&us ' " the information on this application is true and compld re• n n I FIRM NM ELECTRICIAN SCHMIDT LIC NO.:{LL�ii++ ELECTRICIAN ��5 . Licenser. 222 WIWMANTIC DRIVE , Signature LIC.NO.: (Ifapplicabl MARSTONSMILLS,8.7 47A 02648 2 _' • Address. • (508)428.7747 Bus.Tel.No.-211-737 f—IJ Alt.Tel.No.. *Pet M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,l hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/AgentPERMIT FEE:$ Signature Telephone No.