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Home My WebLink AboutBLDE-21-006518 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-006518 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:5/11/2021 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) 26 COUNTRY CLUB DR Owner or Tenant Elaine Tata Telephone No. Owner's Address 26 COUNTRY CLUB DR, 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: Add on A/C&receptacle. 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 1 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. 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 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 �� (24 E..0 e;.::56 c....RG--/''3____ • . ,. CanWnonwra firssackusols , ,...•; Official /Only ,/ c� r E (tet—Le �� VI �� = 2eparimeni o/nre Permit No. rwka BOARD OF Occupancy and Foe Checked FIRE PREVENTION REGULATIONS (Rev. 1/07] . Heave blank) APPLICATION 'FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical CriCE.245 7 AIR 12,00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIONDate: ' City or Town of: YARMOUTH To the Inspector of Wires: • By this application the}finder si ed6ves no, e of his or her intention tot perform the electrical work described below. Location(Street&Nu ber) I G/,& U D \vz l' Owner'or Tenant E�C..\yl � �` '• Telephone No. Owner's Address ' rie A ' Is this permit in conjunctionwith a betiding permit? Yes 0 No c'4 (Check Appropriate Box) _ Purpose of Building t) e.,..v \ fl...5 Utility Authorization No, Existing Service Amps _ Volts Overhead❑ Und rd l; ❑ No,of Itinerate _ New Service Amps / Volta Overhead ❑ Undgrd g ❑ No,of Meters Nuinber of Feeders and Ampacity _ 1 - -- - Lootiop a d Na . e of Proposed Eleet-1 cal Work: i (...)0 1 e i_.A- (14 cu,7---t----r) i& , / t 0 V\ it::__.GC)AfATA rT L14. I� Completion of thefollowing table may be waived by the Inspector of Wires. Na.of Recessed Luminaires No.of Ceti.-Soap.(Paddle)Fans No.of Total _Transformers KVA No.of Luminaire Outlets No.sof Hot Tubs Generators KVA • • No.of Luminaires Swimming Pool soave 0 n- ❑ o 'mergency e g ng . d. Bane Unita No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches i o.o e ec an an No.of Ranges No.of Air Cond. Total Initiating Devices Tons No.of Alerting Devices No.of Waste Disposers Head Pump Number T ns lC No.of Self-Contained - Totals:I"— Der .'�"""� "" Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Locai❑ Municlpal ❑ other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water 'No.of No,of Devices or Equivalent Heaters KWNo.of Data Wiring: SIL s Ballasts No.of Devices or E.uivalent No.Hydromassage Bathtubs No.of Motors Total HP e ecommun cat ons ' r ng: No.of Devices or uivelent OTHER: crc r .S ( £ vC j r .... A.51� Attach additional detail desired or as required by the Inspector of Wires. Estimated Value o 7 In cal Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE G : 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 X BOND 0 OTHER X(Specify;) 1 c^ Q�,S /^ )vp I cerdf,under t'----i--- ---1--"'-- .o_..... �h/V 1 KAP true an f FIRM NAME: WAYNE SCHMIDT y'that the inform, on on th • - esti n Is true and complete ELECTRICIAN . . ,V LIC.NO.: � Licensee:—MARSTONS MILLS iMA 02648...... g E �y te•, r _I v (If applicable,ente1St Hato LIC.NO.: (508)428.3747 na ------____._. Address: Bus.Tel.No.. r. • r , j *Per M.O.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.LiTe.No. .�1 �� '�t at OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner ent. Owner/Agent ' A Signat • ure Telephone No. I PERMIT PPR. e r