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Home My WebLink AboutBLDE-20-001738 Commonwealth of Official Use Only gE Massachusetts Permit No. BLDE-20-001738 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:9/30/2019 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) 171 BLUE ROCK RD Owner or Tenant CHAPMAN C DRUMMOND Telephone No. Owner's Address CHAPMAN ELLEN A, 171 BLUE ROCK ROAD, SOUTH YARMOUTH, MA 02664 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 0 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 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: $50.00 q2._ f p/2./f9, .___ c t (rR / . 66 ret- ckG Commonwealth o f asset ct ,. Official Use Only l 65 >,i -1 .CJa ailment o .�`ira Jarvicas Permit No. ` `'ti�" ` 3• off Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS (Rev. 1/07) • (leave blank) APPLICATION .FOR,PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ,527 2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: 9 S- City or Town of: YAR.MOUTH To the Inspector of Wires: • By this application the iiindersigned Ives notice o hi or her inte ' n to `rform tctrical work described below. Location(Street& mber) 1 3l kJ� (\\ s f Owner or Tenant \J CtJ p n Telephone No.5D$-776,— 3"y ' s Owner's Address .Fail . Is this permit in conjunction with a bu El permit? Yes Ni? (Check Appropriate Box) Purpose of Building D W to \Y Utility Authorization No. Existing Service Amps / Volts Overhead in Undgrd❑ No.of Meters — New Service Amps I Volts Overhead❑ Undgrd ❑ No.of Meters _ _ Number of Feeders and Ampacity pit Lo�gtion and Nature of Proposed Electrical Work: IL ` 1 u asuL is��, ... --:\--d- . fr U A 1 Completion of the followingtable maybe waived by the Inspector of Wires, `. No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of Total Transformers KVA _ No,of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swfmmin Pool A ove In- No.of Emergency Lighting g gird.. grad. � Battery Units No.of Receptacle Outlets No,of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners _ No.of Detectionn Devfc ` No.of Ranges No.of Air Cond. T s i•i NO.of Alerting Devices No.of Waste Disposers Heat Pump umber_Tons No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local❑ Municipalonnectio n 0 Other C No.of Dryers Heating Appliancesr -gecurity Systems:* No.of Devices or Equivalent No.of W ater Heaters KW No.of No.of 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 Vain of E ctric I Vprk: (When required by municipal policy.) 'Work to Start: U i {l` Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OV RA : less 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$ (Specify:) WO cKe s ��n,�ib I certify, under t'-------- - a-----'-'-- -'-.... -"'`a .� �1 WAYNE SCHMIDT y'that the information on this icati tr is true and complete.,, FIRM NAME:- ELECTRICIAN 1� LIC.NO.: Licensee: 222 WILLIMANTIC DRIVE Si meta N applicable,-e,en MARSTONS MILLS, MA 02648.._._ g LIC.NO.:�_ (If PP (508)428-7747 `►+e) Bus.Tel.No.• Address: Alt.TeL No.: /7/ j `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(check one)0 owner ❑owner's agent. 4- Owner/Agent 11i Signature _ Telephone No. I PERMIT FEE: $ 66.--1