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Home My WebLink AboutBLDE-21-006201 Commonwealth of Official Use Only '� Massachusetts Permit No. BLDE-21-006201 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:4/27/2021 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) 40 OAK GLEN VILLAGE Owner or Tenant Ted Parent Telephone No. Owner's Address 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 HVAC. 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 ALA__MS one,► No.of Switches No.of Gas Burners 1 No.of De i •nd e Initiof ` c Q No.of Ranges No.of Air Cond. 1 Total No.of Alert) 1 1 ; )lk 4‘), Tons No.of Waste Disposers Heat Pump Number Tons KW _No.of Self-Conta.r• - Totals: Detection/Alertine t evict/ No.of Dishwashers Space/Area Heating KW Local 0 Municipal O h 81 Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or E s uivalent O 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: $50.00 r-et-1L-,„ C1/( 0.4____ . Commonweal of f/a�sac�/t Official Use Only la.7• ` cc�� pp Permit No. Zc , c. I Ir 28parimani of gire.7arvices O- BOARD OF FIRE PREVENTION REGULATIONS [Rev.v1/07] and Fee Checked 1/07] (leave blank) APPLICATION .FOR'PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C ),527 MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: d)r- City or Town of: YARMOUTHTo the I p ctor of fres: By this application the 4tndersigned gives notice of his o her intention to perform the electrical work described below. Location(Street&Number) O •els� K.\v,c9S 4.1`L7 -U�— Owner.or Tenant c_`� Cl.b^� Telephone No. Owner's Address S�- Is this permit'in conjunction with a building permit? Yes No \ in ❑ , , (Check Appropriate Box) Purpose of Building D W \ f \. Utility Authorization No. Existing Service Amps / Volts Overhead❑• Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity • Logtion and Nature of Proposed Electrical Wor : `• '.. .L1.--_ ' A - 1u r N + p Qiu.,j egg; tilain- i 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- ❑ o.of Lmergency Lighting grnd. grad. Battery Units No.of Receptacle Outlets No.of OR Burners .- .). FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Det W d - InitiatinDevices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals:I � ,Detection/Alerting Devices No.of Dishwashers 'Space/Area Heating KW' Local Municipal - ❑C_onnecdon ❑ Otfier• . No.of Dryers Heating Appiiances , Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts g No.of Devices or Equivalent No.Hydromassage Bathtubs INo.of Motors Total HP ITelecommunications Silring; — No.of Devices or Equivalent OTHER: Attach additional detail if desirea or as required by the Inspector of Wires. Estimated Value f c�5i�ajj Work: (When required by municipal policy.) Work to Start: (Q '''J'�� Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE ERAGE: 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 Iiif BOND 0 OTHER X(Specify:) WO('Kers COOP I certify,under t`----'--- ----'-----►--•-- CO WP SCHMIDT y'that the information on this icati n!s true and complete4CI FIRM NAME:- ELECTRICIAN LIC.NO.: Licensee: 222 WILLIMANTIC DRIVE Si nate ��dAQ MARSTONS MILLS, MA 02648___. g LIC.NO.: -- (If applicable,smite (508)428-7747 •ne.) . Address: Bus.TTel.NNo. J Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt Lic.No. �'�/ — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n— ormally— S required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/Agent 1 Signature Telephone No. PERMIT FEE: $ St I