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Home My WebLink AboutBLDE-21-002866 Commonwealth of Official Use Only ft0Massachusetts Permit No. BLDE-21-002866 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/N INK OR TYPE ALL INFORMATION) Date:11/18/2020 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. Location(Street&Number) 30 MELVILLE RD Owner or Tenant BEARSE BRIAN Telephone No. Owner's Address JOHNSON-BEARSE GAIL, 30 MELVILLE 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement furnace. 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. Total No.of Alerting Devices 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 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 44-74+ 40(14 a LAI tit'1 s4/ _�/V C1673`"C Commo• nweal o`///aslaehtesottt .. OOffficciial,Use Only „' / •si .dJapartmant o f�• s Permit No cro ervicel = `= = Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] • . (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical It CI), 7 1200 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: M YAROUTH To the Inspector of Wires: By this application the pndersi ed gives notice o his or h ritention rm the electrical work descri below. Location(Street&Number) -e X013.y Owner or Tenant G Al L -ea t'SC. Telephone p e No. Owner's Address „SP,-rn J��-•- Is this permit in conjunction with a i;ui)ding permit? Yes )Zi • \ �/� 0 No (Check Appropriate Box) Purpose of-Building D w� 13 Utility.Authorization No, Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity ttion and Nature of Proposed Electrical Work: w • ..LLo i• i m .�,-j A 11iS flirN Completion of thefollowinp table may be waived by the Inspector o 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 Swimmin Pool Above In- No.of Jmergency Lighting • g grnd. ar-nd. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches C. of Gas Burners�� I . No.of Detection and �/ Initiating Devices To No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump Number Tons W No.of Self-Contained Totals: - "�--"- -"KDetection/Alerting Devices No.of Dishwashers Space/Area Heating KW' LocalMunicipal Q Connection No.of Dryers Heating Appliances KW itecurity Systems:* No.of Water No.of Devices or Equivalent No.of No.of Heaters KW Data Wiring: 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 lec .1.Work: (When required by municipal policy.) Work to Start: A. 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: INSURANCEL BOND 0 OTHER X(Specify:) k)cKe s Corte I I certify, under ft---=--- ----'-----"-- WAYNE SCHMIDT y,that the information on this icati n is true and completes FIRM NAME:- ELECTRICIAN LIC.NO.:_=Cl Licensee: 222 WILLIMANTIC DRIVEkatiACI MARSTONS MILLS, MA 02648-.-.Signatu LIC.NO.: (If applicable,ante (508)428-7747 'rte.) Address: Bus.TTel.No.• 7fi j *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt Lia•No. • �zOWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n— o - 5 required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's a ent. Owner/Agent 1 01 Signature Telephone No. • ( PERMIT FEE: $ '