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Home My WebLink AboutBLDE-19-006096 Commonwealth of Official Use Only •E Massachusetts Permit No. BLDE-19-006096 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: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) 21 THACHER ST Owner or Tenant SHEINKOPF DAVID J Telephone No. Owner's Address SHEINKOPF SUSAN L,21 THACHER ST,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 NC. 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/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 $ � %ups' `.3 t.onrnsonweatlh of niaasacLuea• Official Use Only ri Permit No. (cQ /D R k r e1� , apartment of gin Jervicee. << BOARD OF FIREPREVENTION RGU', 'TIONS '[R Occupancy andFee'lan) " ' .. `� (!cave blank) APPLICATION FOR PERMIT TO ERFORM ELECTRICAL WORK All work to be peribtmed in accordance with the M: !achusetts Flee ricai C del t .521 C1 R 12.00 _ (PLEASE PRINT IN INIC OR TYP LL FORMA Date: 23 I r City or Town of: ' '' 0 V To the Inspector of Wires: By this application the undersigned fp es n. ' a of his or her tnt ndon to perform the electrical work described below. Location(Street&Number) 1 . -c-i -e r S�"' —90 \I � � J� Owner'or Tenant F-�r- U AA;ca, Sh e.t%A, cf r& g Telephone No.3622 / Owner's Address • -"` is this permit in conjun.t on with a building permit? s 0 NCgle (Check Appropriate Box) Purpose of Building . k \4,,s Utility,A_ uthorization No. Existing Service Amps • / Volts OV rhead❑. T Undgrd t_i No.of Meters • Nevi Service I Amps / Volts Ov•rhead❑ Undgrd 0 No.of Meters Number of Feeders and AmpacitY Location and Propose n ature of Electrical W/'o�rk: VL_ '"J in Hmite( Cqm,Wane. thefo lowingtable may be waived by the Insp eetorof Wires.-�w No.of Recessed Luminaires No.of Cell.-Susp.(P• •die)Fans No.of Total i Transformers KVA No.of Luminaire Outlets Nb.of Hot Tubs Generators KVA No.of Ltiminaires Swimming Poof•ab' e ❑• In- ❑'1Vo.of$;mergency Lignung i . grn .• grnd 'Battery Units • No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones • No.ofSwitches No.of Gas Burners No.of Detection and f'I�'��' Initiating••Devices No.of Ranges No.of Mr Cond. 'r TonsJ'' No.of Alerting Devices No.• of Waste Disposers. He*1'P mp iumbe i Tons K No.of SeifZontained ' Totals: • I I _ _'",Petection/Alet: ng Devices• No.of Dishwashers • Space/Area Heating KW Local Municipal No.of b yers Heating Appliances Security Cstems:' gym' KW No.Security es or Equivalent ' No.oT Water Heaters KW Na.of No.of Data Wiring: • Sins Ballasts No.of Devices or Equivalent • No.Hydromassage Bathtubs No.of Motors Total HP " Telecommunications Wiring: No.of Devices or Equivalent OTHER: Alta, additional de'rall If desired.or as required by the Inspector of Wires. Estimated Value of lecttrical Work: (Wh required by municipal policy.) Work to Start: cP inspections to be requested i accordance with MEC Rule 10,and upon completion. INSURANCE C ERAGE: Unless waived by the owner,n. •ermit for the performance of electrical work may issue unless the licensee proyides proof of liability insurance including"co .feted operatic'n"coverage or its substantial equivalent. The undersigned certifies that such co erage is in force,and has exh •ited proof of same to the permit issuing office ClIECK ONE: INSURANCE BOND 0 OTHER 0 Specify:) "' I certify;us " " " ' "tat the In i motion on this application Is true and complet FIRM NAt WAYNE SCHMIDT r ELECTRICIAN L iLIC.NO.: D3 1Licsinsee: 222 WILLIMANTIC DRIVE Signatu LIC.NO.: (lfappsee:-. MARSTONS MILLS,MA 02648 • Address: C508)428•7747 Bus.Tel.No. •yam ` "]' ')G�] I 'Per M.O.L.c. 147,s.S7 61,security work requires Departm of Public Sake S License: Alt.Tel.No.. /�7J /� OWNER'S INSURANCE WAIVER: 1 am aware that the Li.•nsee does not hove the liability insurance coverage normally required by law. By my signature below,!hereby waive this r uircment. I om the(check one)❑owner 0 owner's agent. Owner/Agent Signature Tciephon o. _1 PERMIT FEE:$ J