The URL can be used to link to this page

Home My WebLink AboutBLDE-22-001623 or Commonwealth of Official Use Only E` 1 Massachusetts Permit No. BLDE-22-001623 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:9/21/2021 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) 21 THACHER ST Owner or Tenant SHEINKOPF DAVID J Telephone No. Owner's Address SHEINKOPF SUSAN L,21 THACHER ST,YARMOUTH PORT,MA 02675 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 ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for air conditioning 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 E r • I _ 44,1 grnd. grnd. Battervl; No.of Receptacle Outlets No.of Oil Burners FIRE . 1411414kbc 4„. No.of Switches No.of Gas Burners No.of Dete a d(;) Initiative Devi No.of Ranges No.of Air Cond. 1 Total No.of Alerting Device Q Tons 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 ❑ 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 • fte4 Al CKGLf±93 . . . 1 tI soOyComma. ams e/Maddahuue�1 ,fPermitrC, .-Z-_______Z.....--.1‘2.a........_2, Zepa.fm. O/. re Services ; ;";` BOARD OF FIRE PREV,ENTION REGULATIONS Occupancy and Pee Checked aPPLICATIQN 'QR:p�RMt "- --Rev esus blank ----'--- be T TO PERFORNt ELECTRICAL WORK All work to b Aoribrmed in aecot+dance with the Maesaohuaotta 81ooMca!C a (PLEASE PRINT IN INK OR TYPE AU,INFORMAT 1 27 CMR 12.00City or Town of: ' �UT.q Date: 1, ' --1 _ • By this application the d - To the Inspector of Wires. lu+ egri:fed : ves no,. ,fh a .r h Intention to . Location(Street&Number) , ' . perform the electrioal work describ below. v' Owner'orTenant •:a.. 0 +� , Telephone r,i Owner's Address No. Maga is this permit In conjunction with aTiding� � /Purpose of Building permit? Yes ❑ No 1;"41 (Cheek Appropriate Box) Existing Service Utility Authorization No, Amps ....,.,.j Volts Overhead ' - - 8 rvice -__ - - ----- - _ ❑—-Und --- No.ef Met= -- Amps ____L____.Voits Overhead Number of Feeders and Ampacity 1:3 Undgrd El Nd.of Meters Lotto, and Nature of Proposed Eleatricat Works ___c&J.L1--(2.....,../ot 17StA0 1.&1\-\r No.of Recessed Luminaires No. '•lotion o the allow' _ table to• be waived• the Ins,actor o Wires. No.of Ceil.,gusp.(paddle)Panso.o No,of Luminaire Outlets Transfo .ars KVA Neal Hot Tubs • No,of Luminaires Generators KVA Swimming Pool an7° ❑ n' ❑ , .. ' •merge, o , -n No.of Receptacle Outlets d. Matte Units ng No.of Oil Burners ' No.of Switches FIRE itlatALARMS No.of Zones No.of Ranges M' ' • `o.Yaftlatin"°�an Na of Air Cored. a. °� - Tons ,, No,of Alerting Devices No.of Waste Disposers ea ' sup i k: Iii '1:' No.of Dishwashers To else • on rte. logliglonl 'ao D:lection/ to n: Devices Space/Area Heating KW' 'un Na,of Dryers HeatingAppliances Local❑Connection 0 met• o.o f•a er pPIt •ecus ms; Heaters KW 0.o .o.o No.of Devices or E uivalent Si:ns Ballasts Data Wiring: !va No.Hydromassage Bathtubs No.of Devices or E.uivalent No.of Motors Total HP a ecommun cat ons ! r n . OTHER; Na F' of Devic .:or , •a- -1 Gat Attach addition?'detail(fdeslreea or as required by the Inspector o Wires Work to Start; (Wheq required by municipal policy.) f • INSURANCE C E. Inspections to be requested in accordance with MEC Rule 10,and upon completion, , Estimated Value I tri a Work: ka the licensee provides proof of liability insurance including"completed operation"Y ovmer,no permit for the performance of electrical work mayissue the undersigned provides proof such coverage s force, unless BOND ❑ and has exhibited proof of same to thee or its substantial equivalent. The CHECK ONE, INSURANCE permit Issuing I are,under I'--U - a-.... office. W- --4 9CHMIDT OTHER Inform,onion thWO FIRM NAMES "'y,that the! a n and c tnpleta t:LECTRiC1AN €3 Licensee: 222 WILLIMANTIC DRIVE ! l+er, LIC,NO.:...L3_3....€3(7 Licenseeb----e 1ARSTAN MILIA_MA 026 8.;..,.Signatu'� ts+- " ' �. Address: VI 4281.77471has) , LIC,NO.: j ''Per M.O.L.c. J47,a.5 -61,securi • ty Bus.Tel.No: INA c-; — OWNER'S INSURANCE WAIVER: work requires Department of 1'ublio Safety"S"License: Alt.Tel.No.; ►1 .4'�i required by law. ByNiall: I stn, that the Licensee does not have the liability insurance coverage n................................. Owner/A ent myf�iga c b1a w,serasmall f�ISignature 44,_.2. .-.••(_____' kt Waive this requirement. I am the(check one Y ' ...Telephone No. 1.........-- PRI o8r o +er's a ant, u M7T ratan. e •4111,, ..