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Home My WebLink AboutBlde-20-001585 a< Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-001585 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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:9/20/2019 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) 32 EMBASSY LN Owner or Tenant MCCLELLAN JEAN MARIE Telephone No. Owner's Address MCCLELLAN DENISE ANN, 32 EMBASSY LN,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 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- ❑ 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 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 ❑ 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: $50.00 .F-eed-4-5)--- (. ,mmoawsa[h o////a�ach.usejt •. Official Use Only �+ ,1 c� c7 [� Permit No. C%.16 C S V� !f� = 2epartment ol..Y'ire Jsrvice$ • 1 Occupancy and Fee Checked 'r,::; =.� BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] • (leave blank) _ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C) 5ClviR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: 9 T7FT I Cj City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersigned ' s notice of his or her intention to perform the electrical work described below. Location(Street&Number) . i • v L__ _ ` R- Owner'orTenant._.. Y\ Telephone No. 3 C / --5,5 Owner's Address SA-PI Is this permit in conjunction with a bui)ding permit? Yes No )Xi��\ �n ❑ (Check Appropriate Box) Purpose of Building \ 1 \0 Utility Authorization No. Existing Service Amps / Volts Overhead❑, Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity o _ Lotion and Nature of Proposed EIectrical Work: gliwanum Co pletlon oft efollowin_ •ble may be waived by the nsp�ector of Wirer. No.of Recessed Luminaires No.of CeiL-Snsp.(Paddle)Fans No.of Total Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- o.:try Lighting grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No,of Gas Burners� o.of-Detection and / Initiating Devices No.of Ranges No.of Air Cond. Tons .../.. To(3)0 No.of Alerting Devices • No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals:I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local Municipal ❑Connections No.of Dryers Heating Appliances KW ecurity Systems:* No.of Water No.of Devices or Equivalent No.of No.of KW Heaters 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 if desired or as required by the Inspector of Wires. Estimated Value of lectrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C l E: Unless waived bythe owner,nopermit 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 1a BOND ❑ OTHER ► (Specify:) WO cKe s SZ'ctmp I certify, under?- WAYNE SCHMIDT -y,that the information on this Iletes FIRM NAME:- ELECTRICIAN LIC.NO.• q� Licensee: 222 WILLIMANTIC DRIVE ✓ ' MARSTONS MILLS MA 02648_- Signatu LIC.NO.: (If applicable,ente (508)428-7747 'ne.) . Address: Bus.Tel.No.: 0217)No J *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt Lic.�No..• -- OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n—ormally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent ,r Signature Telephone No. ( PERMIT FEE: $ 1 11. N. _