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Home My WebLink AboutBLDE-21-005048 .,�'�► Commonwealth of Official Use Only t P�. Massachusetts Permit No. BLDE-21-005048 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:3/8/2021 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 described below. r� Location(Street&Number) 104 CAPT NICKERSON RD A S� /Y 7 S q q Owner or Tenant BEEBE ERIC J Telephone No. Owner's Address BEEBE KATHERINE M, 104 CAPT NICKERSON RD, 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: Replacement furnace&add on A/C. 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 Initiatine 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/Alerting 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 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 N)A, 41 2( V.f. 61=7-0044 CIN) c& z40(74 jeg Fee,..50 c.lk---,,,,,,)__ _ _______________ . Commonw,a o/Massach.u.4ath Official Use Only �� Permit No. �— 5014 6 t = r� Apartment oi 5ir.Serviced • --±1 f_Z5 g l ., Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev, 1/07j . (leave blank) APPLICATION *FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts ElectricalCgdel �,A7 CMR.12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: JI City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersigned :'ves notice of his or her intention to perform th-,lectrical work described below. Location(Street&Number) •' tii. l tO c.T1.3 t- Owner'or Tenant C et_' it„ Telephone No. 3 ACM Owner's Address Srtier?LS Is this permit'in conjunction with a building permit? Yes 0 No (Check Appropriate Box) Purpose of Building D t&)� \` _ Utility Authorization No. Existing Service Amps / Volts Overhead 0. Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity • LoAtion and Naturereof Proposed po}ed Electrical Work: _ �`y� • • -i ' A ' r I v -- pi3 V' ` r.i ; ` t n ,C� Completion of thefollowinp table may be waivedbytherInspector of Wires. No.of Recessed Luminaires No.of Ceil.�usp.(Paddle)Fans No.of Tom Transformers KVA _ No.of Luminaire Outlets No.uf Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ t'o.of imergency Lighting grad s rn& Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS (No.of Zones No.of Switches No,of Gas Burners 6 No.of Detection and 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: - ""�"""-"""'"- Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local Q Municipal Connection 0 Ot er No.of Dryers Heating Appliancest Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Heaters KW Data Wiring: - Si ns Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP elecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desireg or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start:3,, .,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 BOND 0 OTHER$ (Specify:) c'Kers Cm I cerci , under t'----= - - -- WAYNE SCHMIDT -y,that the information on this icatl n Is ue and complete; �� FIRM NAME:" ELECTRICIAN 1 222 WILLIMANTIC DRIVE A f LIC.NO.: �_q Licensee:----MARSTONS MILLS, MA 02648_ g �,"" (If applicable,erre Sl ust1l LIC.NO.: Address: (508)428 7747 •ne.) Bus.Tel,No.:M52, 42/I 71 J "Per M.G.L.c. 147,s.57-61.security work requires Department of Public Safety"S"License: Alt.Lic.Tel�No.�� (f - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n — S required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner ❑owner's a_ent. t Owner/Agent If 1-4 Signature Telephone No. PERMIT FEE: S.