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Home My WebLink AboutBLDE-21-006519 Commonwealth of Official Use Only or AA Massachusetts Permit No. BLDE-21-006519 - ' 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:5/11/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice or his or her intention to perform the electrical work described below. Location(Street&Number) 52 RUN POND RD Owner or Tenant Dan MacWilliams Telephone No. O Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check App .y at x 4 ° /9 Purpose of Building Utility Authorization No. O z Existing Service Amps Volts Overhead 0 Undgrd 0 No.of M New Service Amps Volts Overhead 0 Undgrd 0 No.of Meter Number of Feeders and Ampacity a Location and Nature of Proposed Electrical Work: Add on A/C. Completion of the following table may be waived by the Ins • o. ires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Tot 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 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 i 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 ---e_e: •:.. CR.G-- ---- . . . ar+s�rwnwaaGrh of///aslac al ...•; official Use Only • V (e • - ,�, c�j� 3Ire No. mac- S ( 7 �1Japarfn�ant of•biro Servkee BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Foe Checked (Rev. l/07j ) ' y • (leave blank APPLICATION 'FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical C C 5127AMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: --L City or Town of: YARMOUTH To the Inspector of Wires: . By this application the lutdet igne• yes notice • his or her i don t. orm a ctricai work describedbelow. Location(Street&Number) W UVB `f` y y a,--- Owner'or Tenant A. )1,1111111V,, - Ct 'v . Telephone No..V33 33 Owner's Address • �y� ,. ��---��-� Is this permit in conjunction with a building permit? Yes 0 No )74 (Check Appropriate Box) Purpose of Building ,T Li�,,, \y\S Utility Authorization No. Existing Service Amps / Volts Overhead❑ U rd ❑ No.of Meters New Service Amps ,,,• I Volts Overhead ❑ Undgrd g 0 No.of Meters Number of Feeders and Ampacity ------ Loction and •,rept'Proposed Electrical W,rk: i1'\cL.LV Y 1 � I Completion of the following table may be waived by the Impactor of Wires. No,of Recessed Luminaires No.of CeU.-Susp.(Paddle)Fans No.of Total Transformers ICVA No.of Luminaire Outlets No.'of Hot Tubs Generators KVA • No.of Luminaires Swimming Pool o 1:3 n. ❑ '.o 'mergency P g ng - ¢r'nd,ve. s;rrtd. Battery Units No.of Receptacle Outlets No.of OR Burners • FIRE ALARMS 1N°.of Zones ' No.of Switches C1rners No.of-Detection an( • • Initiating Devices No.of Ranges No.of Air Cond. Torsi No,of Alerting Devices • No.of Waste Disposers `ea 'ump `um.er_..-Ens ' 4' "o.o e 1 on nos,Totals: " " — Detection/Alertin8 Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 orner Connection No.of Dryers Heating Appliances KW Security brystems:* ' No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.cf 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 Work: (When required by municipal policy.) Work to Start: 5 a tri I Inspections to be requested in accordance with MEC Rule 10.and upon completion. INSURANCE CO ERAG : Unless waived by the owner,no permit for the performance of'electrical the licensee providesproof of-liability cat work may issue unless 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 BOND 0 OTHER X(Specify:) (".e,� I certify,under t`---'--- .._ ---CH -.•_••'•••y,that the Inform, on on this • • cant%n Is true and c m lets. FIRM NAME: WAYNE SCHMIDT A ELECTRICIAN , . _ ,1,f LIC.NO.: 33 Licensee:-----MARSTONS MILLS IMA C 02648.._.. g E �� , LIC.NO.: St nater (If applicable,ante (508)428.7747 'na) Address: Bus.Tel.No.. �I 7 Alt.Tel.No.: j 'Per M.O.L.c, 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. ,— OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage ormally required by law. By 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 PPR. e 1