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Home My WebLink AboutBlde-19-006519 Commonwealth of Official Use Only or NuPermit No. BLDE-19-006519 Massachusetts 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:5/17/2019 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,ttelow.Location(Street&Number) 481 BUCK ISLAND RD UNIT 16 P 7tJ Yeo — Q 3grl Owner or Tenant TRINQUE JANINE A Telephone No. Owner's Address 481 BUCK ISLAND RD UNIT 16FB,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: Replacement HVAC. 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 1 No.of Detection and Initiatinc 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 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 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 " 2 q(5 ? --e?-j-.37) C (Crl Commonwealth o`,//assaclrusetis Official Use Only '�i Apartment / Permit No.(- Q-(Qc( q r -__.,- : o irs&evict3 -1 fr Occupancy and Fee Checked >-:.;_;n.' 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(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 5 113 ) ck City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pet-form the electrical work described below. Location(Street&Number)Lig I Ove S lkl,.d € U VI IT I.P Owner.or Tenant a�►�, V\- --Tr t r.f�►tie. Telephone No. .3 � - 039-� Owner's Address SAY- 1 Is this permit in conjunction with a bui( ing permit? Yes ❑ No It (Check Appropriate Box) Purpose of Building D .AJ \i3 Utility Authorization No. Existing Service Amps I - Volts Overhead ❑- Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd E No.of Meters Number of Feeders and Ampacity e • Lotionnd Naturof Proposed Electrical Work: ( ►r + p cowl) IS Cr- 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.ol:Emergency Lighting - grad. ornd. Battery Units No.of Receptacle Outlets No.of OH Burners FIRE ALARMS No.of Zones No.of Switches (No.of Gas Burners No.of Detection and - ..a) Initiating Devices No.of Ranges No.of Air Cond. l Tons ( No.of Alerting Devices No.of Waste Disposers Heat Pump Number [Tons KW No.of Self-Contained Totals:l ` Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Munici nnectionpal ❑ er Co No.of Dryers Heating Appliances , Security Systems:* No.of Water No. No.of Devices or Equivalent of of Data Wiring: No. Heaters KW 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 Electric 1 Work: (When required by municipal policy.) Work to Start: ,j) ,'_) I LC! 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 ❑ OTHER 2 (Specify:) WO cKers Cowes 1 I certiba, under tL---'-- --'----'-- -'- -•- WAYNE SCHMIDT y,that the information on this a Oic, ',n is a ue and complete FIRM NAME: ELECTRICIAN -{--c6Qor Licensee: 222 WILLIMANTIC DRIVE a. 4 LIC.NO.:� I MARSTONS MILLS, MA 02648 Signatu (If applicable,ente (508)428-7747 'ne.) LIC.NO.: — ____ Address: Bus.Tel.No.: 2/71 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 S required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner o Owner/Agent 1 _ ❑owner's a eat Signature Ill Telephone No. PERMIT FEE: $