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Home My WebLink AboutBLDE-22-000705 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-000705 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:8/9/2021 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) 43 CAPT BLOUNT RD ��,LS 729 13 16to'5 Owner or Tenant MURPHY LEO R Telephone No. Owner's Address MURPHY LINDA M, 1 NICHOLAS DRIVE, FRANKLIN, MA 02038 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: Split NC system. 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. 1 Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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 l�,'`,q- 712d (/o 'co 1-/A)) /l4;k 46 4l C j- i' &. 43/z, Ab) Z—C% b/sc „ 3 Sic.30 fei‘i • �� CI<G:_ f__,' . . • Com3 ii `_� f///adlacal2`! 'Y., Blois! se Only -_1:7-:: aParfinanE oi..7�1ro artrkid Permit No. ' -U��Z2 5i �• `:•;,,,.` BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Pee Checked APPLICATION '�dR�'p�RM(T TO p ev. 1/07] ' eave blank "__'.."' MI work to be performed inaccotdaneewiththeMsssaERFORM ELECTRICAL WORK (PLEASE PRINT IN INK OR TYPE ALL INFO c) sz7 cMR l z,00 City or Town of; OUTN) Date: By this application the undersigned ves noHoe p his ""'------ To the Inspector of Wires: Location(Street&Number) Crr h • t nNon to perform th e ctricai work described below. Owner'or Tenant �• I S Owner's Address Telephone No. Is this permit in conjunction with a bullding wrr t7 Yes Op Purpose of Building �� `n.� ❑ •,,, (Check Appropriate Box) Existing Service Utility Authorization No. """'-~ Amps ....r.,,',�_�Volts Overhead New-- Service 0 Undgrd❑ No,of Meters _ .................. Amps / Volts Number of Feeders and Arnpaci�� Overhead 0 Undgrd g ❑ No, of Meters Lotion and Nature of Proposed Elecrri—Work�� .1.411Lt.....a\X_____Itilc___5„jj...,...S1 - No,of Recessed Luminaires Cam•letlon o the allowin_ table rrr- No.of Cei1,.Sus be waived b the ins.eclor a Wires, No,ofLutninalre Outlets P (Paddle)Fats ~o.o No.'of Hot Tubs Transformers KVA Generators EVA • • No,of Luminaires S n'+l ming pool •rnd e 0 nY 'o.o 'mergency si g ng No.of Receptacle Outlets d• 0 Battery Units No.of Oil Burners No,of Switches FIRE ALARMS No.of Zones No,of Ranges 'o.o s etec on an. • No.of Air Cond. 1111 tultiatin: Devices No.of Waste Disposers 'ea 'nm Tans No,of Alerting Devices Totals:'um :unit: •_Qns_.: " No.of Dishwashers et° e on a ne• Detection/Alertin: Devices Space/Area Heating KW' Local unicipal No.of Dryers Connection ❑ Other `o.o "ater Heating Appliances KW ecurI h' s ems;* ' Heaters KW o•o ^o• o -- ,, No,of Devices or E uivalent --.�..`""`_ _- Si-ns outlasts T�,t, ;iii : �" No.Hydromassage Bathtubs No,of Motors No,of Devices or E uivalent OTHER; Total HP a eCOMr°unic'ations ring; No.of Devicesr E uivalent Estimated Value • Attach addltienal derail if deslrea; or as required by the Inspector Iectri al Work; Work to Start; (When required by municipal policy.) of Wires. Work[INSU St 2, Inspections to be requested in accordance with MEC Rule CO ERA E: Unless waived by the owner,no permit for the performance of e the licensee provides proof of liability insurance including"completed operation's !0,and upon completion, the licensee provides that such coverage is in insurance in,and has exhibited proofelectrical work may lent. CHECK certifies P coverage theee er its substantial equivalent, unless I HrCK under tINSURANCE'• BOND of same to omit issuing 0 OTHER fy,) (' ice,�. P img once, FIRM NAME: -•41". .�_.... (spcci load � c� WAYNE SCHMIDT "7,that the inform on on this .,(�� Licensee: F 222 WILLIMANTIC ELECTRICIAN can n true and complete, (If applicable MARST(50 MILLS MA 0264 'ne.)_Signatu Y'IC•NO,: � 6(��' Address; (508)428.�747 'ne,) LIC,NO,; ---_ J "Per M.G.L.c, 141,s, 57-tit,security Bus,Tel No.: -'`" 7 OWNER'S INSURANCE WAIVER. work requires Department of Public SafeAlt,Tel•No.: required by law. AIVER. I am aware that the Licensee does not have „License: J i Owner/A eat By my signature below,I hereby waive this requirement, I am the(check one L7 L`c No, the liability insurance coveragerage nY Signature. `' 50 ,�I owner ❑owner's a eat . Telephone No, "7—"— PP•RA/fir FP p. Q