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Home My WebLink AboutBLDE-19-002606 � -aCommonwealth of Official Use Only r � Er Massachusettsermit J No. BLDE-19-002606 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.l/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:10/30/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertonu the electrical work described below. Location(Street&Number) 18 WEST WOODS VILLAGE Owner or Tenant LARSON CLAIRE S TRS Telephone No. Owner's Address LARSON WILLIAM F TRS, 18 WEST WOODS,YARMOUTH PORT,MA 02675-1462 Is this permit in conjunction with a building permit? Yes El No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters New Service - Amps Volts Overhead 0 - Undgrd ❑ No.of Meters Number of Feeders and Amp-acity Location and Nature of Proposed Electrical Work: Replacement HVAC. 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- 1:1No.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 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 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 of 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. PERMIT FEE:$50.00 0/2 t {9I/(e ` �? 5Ou CkG 2 . L.ommotuna&of tt/addac tfd le.ci U`O `E' ag cvi ccyy ��77 Serviced Permit No. . . Thsparinwnf of irs Serviced 11 • ate BOARD OF FIRE PREVENTION REGULATIONS (Rev.1/07]and Fee Checked (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527� .00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1O7 I l City or Town of: YARMOUTH To the Inspector of Wires: . By this application the pndm:signed:ivespotice of his or her'Me don to rform the electrical work describ • below. Location(Street&Number) W 'Ilia � t-S _ptrT (SD) Owner or Tenant W 1 ��/V� r NA.ILS. Telephone No. 7gV j 2z /....ca Owner's Address 1- 1 131 Is this permit in conjunction with a bu'ding permit? YesNo T �\� 0 .. (Check Appropriate Box) Pt •ose of Building `J l \ ng Utility Authorization No. 0 x:ting Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters w fJ1 114-- `-i:'le- Service Amps / Volts Overhead > 0 Undgrd 0 No,of Meters N Yu ber of Feeders and Ampacity —• a w ,I O0 +9_,o cation and Nature of Proposed Electrical Work: L• i • riL- V ,5 01 IS .__ .. ... K APL T ` gw �� I I•[acrl1 0 W O Com.tetion o the ollowin_• table m• be waived• the Ins.actor o Wires. O{of Recessed Luminaires No.of CeiL-Snsp.(Paddle)Fans 'o•of Total - � Transformers KVA ,11101 of Luminaire Outlets No.of Hot Tubs Generators KVA ' No.• of Luminaires Swimmiv Pool Above In- No.of Emergency Lighting - g grad- ❑ ornd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches CNo.of Gas Burners-7 .1 o.of Detection and - Initiating Devices To No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number'Tons I KW No,of Sett-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW LocalQ Municipal - Connection ❑ °thee 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; - C p � / No.of De1uces or quiwa�ent�.� J�'FHER: fit•-F>Q jAF,t^-gip F1n`�1,.`�'l� �S/Jc.rW3 ' Attach additional detail i(desire or as required by the Inspector of Wires. cyC Estimated Value q Flectri'gal Werk: (Whet;required by municipal policy.) Work to Start: 1U Mpc Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERA 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 0 OTHER X(Specify:) WO cKa's '-"' I I certify,under P---_-- ---'---t-'---r--'---y that the information on this icati n is true`and' complete.l FIRM NAME: WAY EEC SCHMIRICIAN T P ' ?6q ELECTRICIAN L LIC.NO: _ C1 Licensee: 222 WILLIMANTIC DRIVE Si Hato (If applicable. nteMARSTONS MILLS, MA 02641 _ g LW.NO.: Address: (508)428-7747 'nal Bus.TTel.No.��I 7/ J Per M.G.L.C. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lic.No. -sec 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 a ent 1 Owner/Agent — g Signature Telephone No. I PERMIT FEE: $ 6Q