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Home My WebLink AboutBlde-19-006097 Commonwealth of Official Use Only / ,,� Massachusetts Permit No. BLDE-19-006097 �� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked LRev.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:4/29/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 22 TRANQUIL TRAIL Owner or Tenant BERLIN SUSAN Telephone No. Owner's Address P 0 BOX 327,YARMOUTH PORT, MA 02675 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 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement A/C. 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 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/Alertinc 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 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:) 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,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.149-____t6c, I • `" ComnsoisweaLth o Ma.tiac •. Official Use 9nly Apartment ---(411 6 97_ Sere! Permit No. Q 2)epar ai o�5tre Jswi I i ` '' • - Occupancy and Fee'Checked '' • • ' `3 BOARD OF FIRE PREVENTION REG LATIONS [Rev. I/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK MI work to be performed in accordance with the M sachusetts Electrical Code . 7 CMR 12.00 (PLEASE PRINT IN INK OR TYP LL FORMA _i , Date: I-- 23 I City or Town of: d V To the Inspector of Wires: By this application the undersigned es no ice of his or her i ention to perform the electrical work described below. Location(Street&Number) a fol.,Try i\.• vo.... .Ll... Owner'or Tenant SUS ft h t3•e,C t h Telephone No.3 Owner's Address . ..'"` is this permit in conjunction with a uilding permit? es 0 No (Check Appropriate Box) Purpose of Building j)tJ .S�L Y�. Utility Authorization No. Existing Service Amps • / Volts 0 erhead U . Undgrd 0 No.of Meters view Service Amps / Volts 0 erhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: '' LceQ_4't. 4Ai 04/V4 — f 4- + csiv\\ ,. . _ Co pletlon of thefollowingtable may be waived by the inspector ofWirer_ No.of Recessed Luminaires No.of Cell.-Susp.(P,ddle)Fans No. Tot ' Trans formers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA , No.of Luminaires Swimming Pool 2 b d e ❑ gr;id. 0 No. Units Lighting • 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..Dpvtces No.of Ranges No.of Air Cond. .Y onsl No.of Alerting Devices No.of Waste Disposers Heat Pump Numb.r Tons „IaW -_ 'No.of Self-Contained ' • Totals: • I ; Detection/Meeting Devices No.of Dishwashers • Space/Area Heatin KW' Locai❑ Municipal ection ❑ other J Conn No.of Dryers Heating Appliances KW Sec No ofSysteees or Equivalent No.of Water 'Heaters KW No.of No.of 'Data Wiring: Sims Ballasts No.of Devices or Zquivalent • No.Hydromassage Bathtubs No.ofMotors Total HP Telecommunications Wiring. No.of Devices or Equivalent OTHER: Alta h additional detail if desired,or as required by the inspector of Wires. Estimated Value of Electrical Work: (Wh required by municipal policy.) Work to Start:iii e ili30 Inspections to be requested accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,n„permit for theperformance of electrical work may issue unless the licensee provides proof of liability insurance including"co pleted operation"coverage or its substantial equivalent. The undersigned certifies that such co erage is in force,end has ex ibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 1 BOND 0 OTHER 0 (Specify:) - I certlfp,ut ' ' . "tat the to f rotation on this application is true and conrplet . /' FIRM NAI WAYNE SCHMIDT LIC.NO.: 33tp ELECTRICIAN , Licensee: 222 WILLIMANTIC DRIVE Signatu LIC.NO.: Licensee: MARSTONS MILLS,MA 02648 • Address: (508)428.7747 Bus.Tel.No.; t"."'] 7 P] Alt.Tel.No.. l /%I i *Per M.G.L.c. 147,s.57-61,security work requires Departm t of Public Safety"S"License: Lk.No. OWNER'S INSURANCE WAIVER: I am aware that the Li•ensee does nil have the liability insurance coverage normally required by law. By my signature below,I hereby waive this r.uirement. I pm the(check onc)❑owner 0 owner's agent. Owner/Agent Signature Telephon.No. I PERMIT FEE:$