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Home My WebLink AboutBLDE-19-000802 • Litt§a. Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-000802 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.1/W) 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:8/9/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or tier intention to perform the electrical work described below. Location(Street&Number) 300 BUCK ISLAND RD UNIT 1E Owner or Tenant LAWRENCE KAREN A Telephone No. Owner's Address 98 BLOODGOOD ST,PAWTUCKET,RI 02861 Is this permit In conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Add on NC condenser. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceii:Susp.(Paddle)Fans No.of Total , Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- n 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 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 Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail tfdesired,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 ❑ (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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 rag 1 CkG It4IPCIE , / atIMILOMOVItahhof ASSOCIIOfficial Use Only 'Eleica t Permit No. C:(?-- 3j 2 .- . .4. r 3 lsale.../of.riro Jsoics. _ . , a _ Occupmtcy and Fte Checked BOARD OF ARE PREVENTION REGULATIONS [Rev. I/07] ' (leave blank) APPLICATION FOR PERMIT TO PERFORM EL CTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical cro0 (PLEASE PRINT IN INK OR TYPE INFORMA Date: • to 7 City or Town of: s!—}1-t "ikOTo the Inspector of Wires: By this application the undersign gives noticeofhis or er' en perform the electrical work escribed below. Location(Street&Nnmber)3 d p L 'N` U L l a l Owner'orTenant kO4c�" r L► AJc� Cf Telephone No. ' 66 Owner's Address Is this permit in conjn withoa br�1(�diygg 'per.Amit??^ Yes 0 Nal* (Check Appropriate Box) Purpose of Building 1 /��r��1v /� r J1/\ Utility Authorization No. Existing Service Amps - / Volts Overhead❑ Uadgrd 0 No.of Meters • New Service _ Amps / Volts Overhead 0 Undgrd❑ No.of Meters _ Number Feeders and AProposed rop city • sed / ` \--k_ J „` ,� 1 n c Location//� and azure (of�Pnlrop(o�sed�Electrical Work: W (`'J�,/\ 1j Cake c\ • Completion of the folloivinKtable maybe waived by the fnrpectorof Wier No.of Recessed Luminaires No.of CeiL-Snsp.(Paddle)Fans No.of 'f Transformers KVAVA _ — No.of Luminaire Outlets No.of Hot Tubs Generators. KVA • 'Above In- No.of Emergency Lighting No.of Luminaires " . •Swimming Pool grad.. Q grnd. 0 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 Na ofAlertin Devices .Tonsg No:of Waste Disposers Ileac Pump Number Tons KW No.of Self-Contained Totals . Detection/Atecting Devices No.of Dishwashers • Space/Area Heating KW' fatal0 Munici ecptional 0 OtherConn No,of Dryers Heating Appliances Ky Security Systems:* Na of Devices or Equivalent No.of Water KW No.ol No.ol 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 Dec -cal Work: (When required by municipal policy.) Work.to Start: ��(R' Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO V ERAGE: 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 0 OTHER 0 (Specify.) I certify,ut the information on this application is true and complete.- ��WAY C T LIC NO.: ✓�� ci FIRM NAI ELECTRICIAN Licensee: 222 WIWMANTIC DRIVE Signature LIC.NO.: MARSTONSMILLS, 02648 737 21 I (Ifopplicabi. • (50(508)428-7-7 74747 Bos.Tel.No.: ) • Address: - Alt.Tel No.. *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 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 ❑owner's agent. Owner/AgentPERMIT FEE:$ SignaturetuneTelephone No.