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Home My WebLink AboutBLDE-19-006322 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-00632_45 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:5/8/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of has or her intention to pertorm the electrical work described below. Location(Street&Number) 191 ROUTE 6A Owner or Tenant MCCONNELL JESSICA M Telephone No. Owner's Address 191 ROUTE 6A,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: Add on NC. Completion of the following table may he 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 3 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 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 :5(-ej 7 ( 8((q ree6rc)_ CWIacIS C.j__ r� Elf M/1 / al Official the Only (,oRwaallk o f///W�achads C`�e Permit No. `t��q - 3 ZZ , � .(J WiIIWIK O grow fft/IGY9 • ,_-_ e+ P - •• - 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 Code .5 7 CMRG 12.00 (PLEASE PRINT IN INK OR LL NFORMA Date: 3 I - Cityor Town of: 00 To the Inspector of Wires: By this application the undersigne es no ice of his or intention to perform the electrical work described below. Location(Street&Number) l • , A- y- rt —0 6 wner'or Tenant S.S t� ,.IL.f' -)11 r e-1 Telephone No. O • wner's Address `f— �Q'� . Is this permit in conjunct on with a uilding permit? Yes ❑ No e� (Check Appropriate Box) Purpose of Building p .c.A q • Utility'Authorization No. • �--•� Existing Service Amps / Volts Overhead❑. Undgrd❑ No.of Meters • )`iew Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity (IYY\ � \� Location and Nature of Proposed Electrical Work: \]J\ V,..) Col\ke,v ,se\ • • Completion of the followin table my be waived by the Gupectorof Wires,,, q.of Total No.of Recessed Luminaires No.of Ce11.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA , • •above 1n- No.of It:mergency Lighting ' • No.of Luminaires Swimming Pool grnd.• ❑• xrnd. 0 ;Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones Nb.of Detection and No.of'Switches No.of Gas Burners Initiating•.Devices Total 13 No.of Alerting Devices No.of Ranges No.of Air Cond. Tons • Heat Pump Numb r Tons KW No.of Self-Contained • No.of Waste Disposers Totals:,.. ""• 1 "'"'"'�'"""•"""--- Detection/Aleszting Devices .No.of Dishwashers Space/Area Heating KW Local i Municipal Connection Q w HeatingAppliancesKW tecurlty Systems:* No.of Dryers No.of Devices or Equivalent No.of Water No.o` No.of 'Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent • telecommunications Wiring. No.Hydromassage Bathtubs . No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired.or as required by the Inspector of Wires. •, mated ' ue of Electrical W 5 K (When required by municipal policy.) Work.to Start. Inapectibns .o be requested in accordance with MEC Rule 10,and upon completion. ' 1 . ► • COVERAGE: tfnless 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 co erage is in force,end has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER El (Specify:) I certify,ur • . "'tat the information on this application is true and complete. 2(' WAYNE SCHMiDT LIC.NO.: 3J`P FIRM NAI ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE Signature W LIC.NO.: a ltcabl. Bus.Tel.No.:MARSTONS MILLS,LS,MA 02648 •- V. (if pp (508)48.7747 Alt.Tel.No.? • Address: ., `Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety S„License: Lic.No. 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((Ieck one)0 owner 0 owner's agent. Owner/Agent Telephone No. I PERMIT FEE: $ w i Signature