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Home My WebLink AboutBlde-19-006703 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-006703 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:5/28/2019 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) 35 MCNAMARA AVE Owner or Tenant ANDERSEN SUSAN Telephone No. Owner's Address 35 MCNAMARA AVE,WEST YARMOUTH, MA 02673 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: Split A/C system. 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 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 i—r _ee_ ____________-,,0 d, U'CV`f_ "_ . ComanonmsaaL o////a6sac�(� fficial Use Only _ cc:: l . 9 artansnit o .tire�srvtcss Permit No. �'vie�� -f Occupancy and Fee Checked - — 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 ( C),5 CMR 12.00 (PLEASE PRINT IN INK QR TYPE ALL INFORMATION) Date S /(C 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) s- • Owner.orTenant SV S..L,v� .-ere e r Telephone No •7 (3— i'� Owner's Address „I-r Is this permit in conjunction with a bui ding permit? Yes :I Ni?. (Check Appropriate Box) Purpose of Building D \ Utility Authorization No. Existing Service Amps / Volts Overhead ❑, Undgrd❑ No.of Meters New Service Amps I Volts Overhead❑ Undgrd -- 0 No.of Meters Number of Feeders and Ampacity LoAti and Nature of Proposed Electrical Work: j . (rC.... )..,5-1 °-ilit , Completion of the followin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No,of tal Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting — • grnd. grad. u Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches (No.of Gas Burners No.of Detection and / Initiating Devices No.of Ranges No.of Air Cond. Tons! L-No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons K No;of Set-Contained Totals:l "�' { Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW• Local❑ Municipal ' Connection ❑ �'� No.of Dryers Heating Appliances KW ecurity Systems:* No.of Water No.of Devices or Equivalent No.of- . No.of KW Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Eiathtubs- No.of-Motors Total HPTelecet::munications Wiring: I No.of Devices or Equivalent OTHER: , Attach additional detail if derirec4 or as required by the Inspector of Wires. Estimated Value of Elec 'cal Work: (When required by municipal policy.) Work to Start: 3Q Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE G : 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 X BOND 0 OTHER�((S ci I certify, under t'- --= �_• r.. • Jc . Pe fy:) �K '� WAYNE SCHMIDT Y,that the information on thu •, is �n is true andcomplete. FIRM NAME:- ELECTRICIAN / LIC.NO.: ? Licensee: 222 WILLIMANTIC DRIVE r✓ ' , —MARSTONS MILLS, MA 02648__ Signatu (If applicable,ente (508)428-7747 ne.) LTC.NO.: Address: Bus.Tel.No.: �I 7/ __I *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lic.Te No. ,� OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n — S required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's a ent. Owner/Agent 01 Signature Telephone No. `PERMIT FEE: $