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Home My WebLink AboutBlde-21-001443 Commonwealth of Official Use Only -�.;t NttiMassachusetts Permit No. BLDE-21-001443 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL , I RK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 :I? q (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date'9/22/2020 : t , City or Town of: , YARMOUTH To the Inspector of Wires: �' ` „ g• r By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. SFP �<' Location(Street&Number) 79 MID-TECH DR UNIT A f44A-DtE.- 6l .,,, -9.) Owner or Tenant Tele hone No. 4'' 4-(' --,,., 5 l Owner's Address F i.66JA�Y,79 MID-TECH DR UNIT A,WEST YARMOUTH, MA 02673 ``<:; 1' Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box`T, `'t ,-.., 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 o.of Meters Number of Feeders and Ampacity O // Location and Nature of Proposed Electrical Work: Replacement HVAC. Z3 • �f Completion of the folio 16' 7J[spector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of /�-� tal Transformer , 7 �' No.of Luminaire Outlets No.of Hot Tubs Generators 44'A No.of Luminaires Swimming Pool Above 0 In- ❑ No.of Emergency Lighti io 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 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/Alertinc 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 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:$80.00 CL::c (tv0 0 I/20/7-w F-ez-zo , cl<cr'--2 . C.,mmonmsa&o////a�ac f Official Use Only /�] C� Permit No. . .1_Aii, .2 1 c7 3 _ s+ aparfmanE o Ji,'`Serviced -T- 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 C en 12.00 (PLEASE PRINTIN INK OR TYPE ALL INFORMATION) Date: 1°TTLJ(� City or Town of: YAR1VIOUTH To the Inspector of Wires: . By this application the pndersi ziyes notice.of hjtor er intention to perform the electrical work described below. Location(Street&Number) C a k . Owner.or Tenant Q y" Telephone No. q Owner's Address SA" ' Is this permit in conjunction with a I;uiiding permit? Yes 0 No N~4 (Check Appropriate Box) ' Purpose of Building n Li \\ y\0 _ UilityAuthorization Nei-- Existing Service Amps / Volts Overhead Q Undgrd❑ No.of Meters New Service Amps / Volts Overhead Q Undgrd❑ No.of Meters Number of Feeders and Ampacity • Lotion and Nature of Proposed Electrical Work: Completion of the followinvable 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 l�;mergency 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 ,.l No,of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Feat Pump Number Tons KW No.of Self-Contained Totals:I "} Detection/Alerting Devices No.of Dishwashers Space/Area Heatin KW' Municipal g Local❑Connection ❑ P' No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent No.of Heaters KWData Wiring: Signs Ballasts No.of Devices_or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent • Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Elec c I Work: �� ' (When required by municipal policy.) Work to Start: 9 �tG 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 Igt BOND 0 OTHER X(Specify:) ( j Cowl) p I certrfy, under t'— ---`_-`--" __ WO lc s e a ' 1 FIRM NAME: WAYNE SCHMIDT �',that the information on this Oicatr n is ue and complete. ELECTRICIAN LIC.NO.: 22Licensee: RS WILLIMANTIC MILL TIC DRIVE ✓ applicable,—, —MARSTONS MILLS, MA 0264R Stgnatu LIC.NO.: (If PP (508)428 7747 'ne) Address: Bus.Tel.No.: /7/ J *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt. Tel.No Lic.No..: — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n— o m jy S required by law. By my signature below,I hereby waive this requirement. I am the(check one 0 owner Owner/Agent a______ 0 owner's . Signature .L,_ t al Telephone No. PERMIT FEE: $ , s Tr