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Home My WebLink AboutBLDE-19-001541 I. — Commonwealth of Official Use Only No Massachusetts Permit No. BLDE-19-001541 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked FRev.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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:9/13/2018 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) 481 BUCK ISLAND RD UNIT 14 Owner or Tenant BEST KENNETH E Telephone No. Owner's Address BEST PATRICIA A,481 BUCK ISLAND RD UNIT 14HA,WEST YARMOUTH,MA 02673 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 ❑ 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: Replacement HVAC.(UNIT 14-H) 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 ❑ In- ❑ 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 1 No.of Detection and Initiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 Stens 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 ❑ (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 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 C./c et II if 46 Ct &Z e_5 0 „., C di(GtIR-CDC • Lommonweakk el t t/addac its Official Use On1yyz4c`� gin gq_ VP 11epartmeni o1.}in Serviced Permit No. ;_ , • BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ev. 1/07] . (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C 527 12.00 ! (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ,.1 't , ' City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned givesUnotice of his or her int tion • pee o the electri - wo •d s 'b . below. Location(Street&N i ber) 0 111' .. .4 1\l _ �- Owner'orTenant /.s I Telephone No. —Ji(l(7 Owner's Address At M. Is this permit in conjunction with a buding permit? Yes El No. (Check Appropriate Box) Purpose of Building D (�)&.\i \ yt, Utility Authorization No. Existing Service__ Amps /` Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd g 0 Ne.of Meters Number of Feeders and Ampacity a Lo tion and Nature f Proposed Electrical Work: w �i Ri>:�e�ak� Completion of the followingtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL�usp.(Paddle)Fans No.of Total Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators ICVA • No.of Luminaires Swimmin Pool Above In- 'No.of Emergency Lighting g arms. ❑ ams.❑ Battery Units No.of Receptacle Outlets No.of O0 Burnersr1 No.of Detec FIRE ALARMS INo.of Zones No.of Switches �No,of Gas Burners � 1. tion and 1111 Initiating Devices Toel LLL No.of Ranges No.of Air Cond. Tons 01.% No.of Alerting Devices No.of Waste Disposers Heat Pump I• Number Tons I KW No.of Self-Contained - Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local Municipal Q Connection other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: 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 required by the Inspector of Wires. Estimated Value of lee al Work: (When required by municipal policy.) Work to Start: ( g Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C 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 X(Specify:) WO cK 's Cawp I terfify, under t----'--— --r----4.---'7,that the information on this icarl n is true and' complete WAYNE SCHMIELECTRICIAN T y' sem'��q FIRM NAME: ELECTRICIAN LIC.NO.: bK Licensee: 222 WILLIMANTIC DRIVE Si aaN (Ifapplicablele,enteMARSTONS MILLS,MA 02648._ g LIC.NO.: Address: (508)428-7747 fie) Bus.Tel.No.:`I Z�Q'yl�02I-t1 j 'Per M.G.L.c. 147,s.57-61,securitywork requires _ Alt.Tel.No.: t� / — OWNER'S INSURANCE WAIVER: I am are that Departmenthensees does norhavethe liability insurance coverage normally e: Lic.No. �t required by law. By my signature below,I hereby waive this regwremrnt I am the(check one) owner ❑owner's agent t Owner/Agent — g Signature Telephone No. - I PERMIT FEE: $