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Home My WebLink AboutBLDE-21-005047 Commonwealth of Official Use Only atritto Massachusetts Permit No. BLDE-21-005047 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:3/8/2021 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) 26 WOOD RD 97 Y 36 g-- `N* Owner or Tenant Michael Taylor Telephone No. Owner's Address 26 WOOD RD,SOUTH YARMOUTH, MA 02664-4141 Is this permit in conjunction with a building permit? Yes 0 No 0 (Chec A' s V • Box) Purpose of Building Utility Authorization No. IF Existing Service Amps Volts Overhead 0 Undgrd 0 New Service Amps Volts Overhead 0 Undgrd 0 (.o' •t• • Aker Number of Feeders and Ampacity dVVV 117 Location and Nature of Proposed Electrical Work: Remodel per attached. U Completion of the following table may be wai ector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of al Transformers A 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 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: $75.00 EUt i/1/24 yy� , ConunonureaFee. -7 cl(6-''L3:3 o f s/assaceli . '.r,... ata se Only c�j� �� -1Japarfinant al JJr.&rvkea Permit No. �.2.-C r s� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Pee Checked CRay.1/07] . (leave blank APPLICATION 'FOR:PERMIT TO PERFORM ELECTRICAL MI work to be performed in accordance with the Massachusetts Electrical Code t +=C),52 000 WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATI Date: 1 City or Town � 'Tly By this application the><u of: r---- ,__� To the Inspector of Wires; gn gives no t of`Ins or•er itch • to pa ori the electrical work described below. • Location(Street&Number) r , � 1 �, ��i S Owaer'orTenant A/ MAIM Owner's Address Telephone No. — 4°.40 Is this permit In conJunetion with a bka�dtug permit? yes Purpose of Building �� ❑ N0• A (Check Appropriate Box) Purpose Service ��`A uthorhation Nu, Amps _________,_,,_ rd New Service gVolts Overhead❑ Und ❑ No.of Meters New Se---. Amps 1 wVolts Overhead 0 Undgrd Nuinber of Feeders and Ampacity B 0 Na,of Meters Lotion and Tiro(Proposed Electrical Works Q V�(� 1 Lv-er , ,,, , - ►: 1.1 im . . Mr _Man= �'.�tea. Cont•le •n o the allow! _ table tit• be waived., the Ins.actor a Wires. No.of Recessed Luminaires No,of Cell.-Soap (P ) `o.o No,of Luminaire Outlets addle Pans • Transfo •ars KVA No.of Hot Tubs Generators KVA No.of Luminaires Swiratniag Pool _rude 0 n. I-, ' '. ' 'merge° v . ng • No.of Receptacle Outlets d. Batts Units No.0f 011 Burners No.of Switches - FIRE S No.of Zones wit„ - - . __ • .o.0 Pe ee4en an. No.of Ranges ` ' /taint's;_ Devices No.of Air Cond. ° No.of Alerting Devices No.of Waste Disposers Tans "ca mpals. ,•_um.of ons ' "«� o.o a on.. No.of Dishwashers Detection/Ale:tin Devices 'un c pa Space/Area Heating KW' Local Connection No.of Dryers 0 ��' Heating Appliances KW .ecurt $s ems: `o,o "star No.of evices or E.uivalent Heaters KW `o.o `o.oData Wiring: SI_ns BallastsNo.of Devices or E.uivalent No.Hydromassage Bathtubs No.of Motors Total HP a aco :nu c ons '' r ng:OTHER, `g No.of Devices or ' •uiva�ient MIIIMMMEIrr . Estimated Value Of IeC Cal Work: Attach additional detail(Modred or as required by the Inspector of Wires, Work to Start: (meq required by municipal policy,) Work t Start: CO inspections to be requested in accordance with MEC Rule 10,and upon completion. GE: Unless waived by the owner,no permit for the performance of electrical work mayissue the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. undersigned certifies that such coverage is in force,and has exhibited proof of sante to the permit issuingoffice. unless CHECK ONE: INSURANCE q lent. The tee ,Wader 1N - RANCE X BOND 0 OTHER Spoci tel' -a_.. _.�.._ .'_..... �t �) FIRM NAME; WAYNE SCHMIDT 7'+that the Inform, •on on this;,% true and a to l ELECTRICIAN A eta Licensee: 222 WILLIMANTIC DRIVE !s Vr► LIC.NO.: (lfappltcoble'ante--MARSTONS MILLS MA 02648...._Signatu mg, to . II Address: (508)428. 747 +na) LIC.NO.; jMir"Par M.O.L.c, 147,a.57-6 t,security Bus,Tel.No.. r.~`; OWNER'S INSURANCE WAIVER.: WOrk requires Department of Public Safe +'s++ Alt.Tel.No.: _;If J -1 / required bylaw. IVER; I am aware �' License: Lin.No. r that the regWao does not have the liability insurance covers a n1""""-- qBy my signature below,I hereby waive this requirement. I am the(chock one Owner/Agent � g !molly ,`' Signator° owner owner's a ant Telephone No. .' PRRM•rT RRR. e