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Home My WebLink AboutBLDE-19-000948 1 - Commonwealth of OfftcialUse Only at Massachusetts Permit No. BLDE-19-000948 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 (PLEA SE PRINT IN INK OR TYPE ALL INFORMATION) Date:8/17/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perlorm the electrical work described below, Location(Street&Number) 121 WHARF LN Owner or Tenant BEARD WILLIAM J TR Telephone No. Owner's Address BEARD CYNTHIA J TR, 167 KEMP ST,GROTON,MA 01450 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 0 Undgrd 0 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: Replace SEU cable&meter trough. 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 o ln- ❑ 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 Disposes 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:) 1 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,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 0 owner's agent. Owner/Agent Signature Telephone No. PERAKIT FEE:$50.00 So gzo (f8 Oa CI<G,AS6 . • Corrunonarea[!h of/t/aafacirusril! fficialUse Only ii. t�A 7 Permit No. (---179.—.10 44 a,!Ef art..'of Jin�avicd h Occupancy andee Checked o. BOARD OF FIREPREVENTION REGULATIONS [Rev. I/071 (leave blank) • APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( W 12 .00 (PLEASE PRINT IN INK OR ALL INFOROIV) Date: f City or Town of: To the Inspector of Wires: By this application the undersign nes notice of his Pr her inter n to pert the el cal work described below. Location(Street&Number) e ` a - Owner'orTenant C, ']'. ' e ` e IJ Telephone No. Owner's Address s • / Is this permit in conjurrEtibp m� 'th a Luildi�e c it? Yes 0 No (Cheek Appropriate Box) Purpose of Building (�/)1VAv e.."\i\ Utility A tborisation No. Existing - Amps - / Vo Overhead 0 Undgrd 0 No.of Meters\ y \ New Service _ Amps / Volts Overhead Overhead 0 Undgrd 0 No.of Meters m Nuber of Feeders and Ampacity `1 /�� t� j Se ah d urc posed$\et:frical pVprk:t �\. \ / U IIPP�I111L�1111..�fj/�� • Completion of the follow/n&table may be waived by the InrppeecctorofWirer. ti No.of Recessed Luminaires No.of Ce ILSusp (Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot TubsGenerators KVA 'Above Jr,.. No.of Emergency Lighting No.of Ltiminalres • . . Swimming Pool grad ❑ grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones • No.oiSwitches No.of Gas Burners No.of Detection and Initiating DeWCes Total No.of Ranges No.of Air Cond. .Tons NaofAlerting DlWtes No:of Waste Disposers( Heat Pump Number Tons MW No of Self-Contained.: i` ) Totals:• Detection/Atertia Devices No.of Dishwashers Space/Ara Heating KW' Local❑ Mnnle(ps) 0 Other 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 thtubs . No.of Motors Total HP Telecommunications No fDevices or EqWiruivalent of Devices Equivalent OTHER: 3 Attach adds • d detail iifdesirer(oras required by the Inspector of Wires. Estimated Value Elec call World (When required by municipal policy.) Work to Start: 15 1.-1: Inspections to be requested in accordance with MEC Rule I0,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,rind has exhibited vroof of same to the perp it issuing office._ CHECK ONE: INSURANCE . BOND ❑ OTHER 0 (Specify:) I certify,ur - ' • the information on this application is true and completetsscNi WAYNE SCHMIDT FIRM NAI LlC.NO.. ►►r+i+i �^1/ ELECTRICIAN P . - Licenser. 222 WIWMANTIC DRIVE Signature LIC.NO.: Qjopplicabf MARSTMILLS,MA 02648 ` _171 (508)428-7747 Bus.Tel.No.: - Address: - Alt.Tel No.. *Pa 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)0 owner 0 owner's eat. Owner/Agent Signature Telephone No. PERMIT FEE:S