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Home My WebLink AboutBlde-20-003121 {.(\ Commonwealth of Official Use Only a Pm Massachusetts Permit No. BLDE-20-003121 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:11/27/2019 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 ibed below. Location(Street&Number) 157 ROUTE 6A ''LLB.tt-Q, Cse Owner or Tenant WATANABE YUJI Telephone No. Owner's Address WATANABE ALDA M, 157 ROUTE 6A,YARMOUTH PORT, MA 02675-1713 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: Install receptacle&change out smoke detectors. 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. Total No.of Alerting Devices Tons___ _ Heat PumpNumber Tons KW No.of Self-Contained No.of Waste Disposers 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 Siens 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 ❑ 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: $80.00 ViA f l q te .- , ( '-_, 1:z3, F.-./ L-C?A' 7—ZA77 Fet5L c1kJ2 — COrnmon of Madsach.tts • , ,,..;: Official Use Only c/� 3I Z ( '' mil__ 2epartmcnt o/5ke Servta.d Permit No. -T w Occupancy and Fee Checked • BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07j peeve blank) _ APPLICATION .FOR'PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),52 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: [ 112 -j 1 ci City or Town of: YARMOUTH To the Inspector of Wires: . By this application the>uundersigned gives noticeof his or er intention to rform the electrical work described below. Location(Street& umber) 1 fi' A- —Pon-7 • ,3c Z' Owner•orTenant Y\60 j) J po-k_y\-es e -€STC1vM1 neNo. ,) Sg2..._ Owner's Address .fr)-J . Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building_ �,., �/� f-k� Utility Autirut-Ixbtion No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters _ Number of Feeders and Ampacity Lo tion and Nature of Proposed Electrical Work: 1 geC .mot \ 0 Comp etion of the followinktable may be waived by the Inspector of Wires. tal No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tr.Tra nofsformers KVA VA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad., grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of Detection and No.of Switches Tfi:of 'sss� eerso� In tlatttna Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices 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❑C nneiction 0 Other No.of Dryers Heating Appliances KW -Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW_ , _ No.Hydromassage Bathtubs No.of Motors Total HP Telecommunit:'ations gg \ No.of Devices or uivalent �� "e- Kt-to-eA,' -I�+ jJër/vao'ii sOTHER: C l Oseof PIO4 . Attach additional tail if desired or as required by nspector ofWires. Estimated Value of Elec •c 1 Work:G (Wheq required by municipal policy.) Work to Start: 1 1 j l /l Inspections 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 X BOND 0 OTHER x(Specify:) WO CKe G.ND^tp WAYNE SCHMIDT 1',that the Information on this icati n is true and complete. �' FIRM NAME:- ELECTRICIAN LIC.NO.:� G'R1 Licensee: 222 WILLIMANTIC DRIVE —MARSTONS MILLS, MA 02648..._.Signatu CttlACt LIC.NO.: (If applicable,ente (508)428-7747 'ne.)Address: Bus.TTel.Nao.• �'(! 7/ 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 normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. S% Owner/Agent o 1 Signature Telephone No. I PERMIT FEE: $ 60 I