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Home My WebLink AboutBLDE-22-004382 „ ' Commonwealth of0 official Use Only ifilk '` Massachusetts Permit No. BLDE-22-0-04382 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:2/8/2022 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) 29 ELTON RD Owner or Tenant BLAJDA DANIEL A Telephone No. Owner's Address BLAJDA SANDRA L, P 0 BOX 1294,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: Miscellaneous work per attached. 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 Initiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 Ballasts Data Wiring: Heaters Siens 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 perjuiy,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: $50.00 gig,,, . CirGO* . 9, ) • • • Commonwealth of/rla66acluusalfd Offioial Use Only r' Zc� Permit No. E� -43✓"1,v epa�rhment o f e....cervices BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Pee Checked [Rev. 1/07] (leave blank) APPLICATION. FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the assachusetts Electrical Code (PLEASE PRINT ININK O' r ; :. L r . • c ,. Al Date: 527 CMR 12.00 City or Town of: To the Inspector of Wires: By this application the undersi! -: yes n'. e •f his or her A on to perform the electrical work described below. Location(Street&Numb r) . 1A 7r. /j Owner'or Tenant Sfrlidi tD Q,V Q Owner's Address 5 Telephone No. 7$' Is this permit in conjunction with building permit? Yes_ 0 No Pur Bullding j)1 t -� _ (CheckAppropriate Box) V" v Utility Authorizationon No. Existing Service Amps . / Volts Overhead New Service 0Undgrd❑ No.of Meters Amps / Volts Overhead El No.of Meters Nplaefty UY\ `) CuC Li— Q.Y\Ok ils L L•ocation nd Nature of Proposed Electrical Work; N : Completion of thefollowl table may be wan y the Inspector of No.of Recessed Lumir i, fj. n --c- -. •�.-..._.. __ .of _ Total iers KVA • No.of Luminaire Ou 1.. � J�• v I �h s KVA No.of Luminaires L�.,�,� •' ^- V ergency Lighting No.of Receptacle On mks • -- � ""'WSlf�/ �' �'1 LRMS !No.of Zones No.of Switches f ection and No.of Ranges L �� ing Devices ;J rting Devices No.of Waste Dispose TO. lM.cI S It -Contained No.of Dishwashers Alerting Devices Municipal connection ❑ Other No.of Dryers stems:* No.of Water Devices or Equivalent Heaters • D ices or Equivalent • No.Hydromassage Bathtubs INo.of Motors Total HP •Telecommunications Wiring: OTHER: Li(� rk„ti No.of D ces or Equivalent Loirtwt...)--rj 4 • Estimated Val f ectrieal Work: Attach adithku ltlona it If desired or ed by the Inspector of Wires. ��`� n� (When required by municipal policy.) Work to Start• `,9% 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 co erage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANC BOND 0 OTHER 0 (Specify:) ---'_' I certify,ur -�._.._ . .. ...._..-slat pl �" FIRM N WAYNE SCH M I DT the information on this application Is true and compk AI ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE LTC.NO.: ( ensee: � p 3 MARSTONS MILLS, MA 02648 (508)428-7747 Signature LIC.NO.:_ • Address: Bus.Tel.NNo.• .751.��-pl . 'Per M.G.L.c. 147,s.57-61,securitywork requires D Department of Public Safety"S"License: LiAlt. c.•No.•• ep 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 . owner Owner/Agent CI Owner's a ent. Signature Telephone No. PERMIT FEE:$