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Home My WebLink AboutBlde-22-003527 Commonwealth of Official Use Only r � Massachusetts Permit No. BLDE-22-003527 l` 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:12/26/2021 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) 34 STUDLEY RD Owner or Tenant OLEYER GEORGE R Telephone No. Owner's Address OLEYER SUSAN WALL,467 QUAKER FARMS RD, OXFORD, CT 06478 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 ❑ 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: Recessed lights&dimmers. 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. Tonal 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 ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs 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 my 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 Olt A ( 4 (vi,-/(-e--- ;Ffej..12_. Ci(61:45.0 . • A enmmonweaah o///laesack selfd • Official Use Only �M� Pertnit No.(i2Z—352 x1• y .eparf nt o/.ire..S'e vicee / !( J • BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Pee Checked ";_•ylll� • [Rev. 1/07] (leave blank APPLICATION. FOR PERMIT TO PERFORM EL CTRICAL WORK All work to be performed in accordance with the assachusetts Electrical C d S 12 0 (PLEASE PRINT IN INK O' ;re :. ( 4 ; , r,) Date: City or Town of: ,�`;� 'v��Si To the I s ector offires:By this application the undersign-i _4 vas no cc f Ws or h tention to pe th electrical rk des bed below. Location(Street&jmber) `� /� Owner'or Tenant .QC, Telephone No. (� Owner's Address • • Is this permit in conj n w h sAbVildingpermit? .Yes fl No (Check Appropriate Purpose of Building ` Box)Utility A thoMxation No. Existing Service Amps • / Volts Overhead ❑, Undgrd g 0 No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters _____ Number of Feeders and Ampacity L_I1.4 c on gnd�v,re of ropose ectrical Work; A- e_ccet rs / 0 01 vvi liter r rtiTh-t l Ne:w 1 f1 eS 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 TotalTransformers . No.of Luminaire Outlets No.of Hot Tubs Generators KVA . • No.of Luminaires Swimming Pool grade ❑ In- ❑ No. Units Lighting No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners •ofDetection and Initiating Devices No.of Ranges No.of Air Cond. Ton ,No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Togs J KW• No.of Self-Contained Totals: """"""'" """'""' '""`]"""" ""' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local Municipal ❑'Connection 0 other No.of Dryers Heating Appliances KW Security Systems:* No.of WaterNo.of Devices or Equivalent No.of No.of Heaters KW Data�Yyring: Signs Ballasts _ No.of Devices or Equivalent • No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wirin : No.of Devices or Equivalent OTHER: • Estimated• Valu E a Attach additional detail 'desired or as required by the inspector of Wires.- (When required by municipal policy.) Work to Start actions 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 co erage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANC BOND El El (Specify:) I ce116 u1 "-- WAYNE SCHMIDT • ^- tat the Information on this application is true and comple FIRM NAI ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE LIC.NO.: aolo ( appltcabl� MARSTONS MILLS, MA 02648 Signature LIC.NO.: • Address; (508)428.7747 Bus.Tel.No.• 17 *Per M.G.L.c, 147,s.57-61,security work requires Department of Public Safe S License: Alt.Lic.Tel•No.No.M. ' 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 .III owner II owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE:$