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Home My WebLink AboutBLDE-22-005516 0\0v Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-005516 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:3/31/2022 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) 8 PIERCE ST Owner or Tenant Tony Clampa Telephone No. Owner's Address 8 PIERCE ST,WEST YARMOUTH, MA 02673 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: Wiring for 3 head split 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 Emergency Lighting AT 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. 3 Total No.of Alerting Devices 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 Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent 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 perjuiy,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 fir"..5.° . dc.41396---- 1 t�j • Commonweatk o/�/laasaosusst14 �Off'ioial Use Only r E, Permit No. �ZZ Thepariment al giro�ervkea • f` 'Y BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Pee Checked •"j41 (Rev. 1/07] (leave blank) APPLICATION. FOR PERMIT TO PEaFORM ELECTRICAL WORK All work to be performed in accordance with the sachusetts Bleotrical Code (PLEASE PRINT IN INK O' I' ' - ,• r . e . 'i� Date: 527 CMR�2 9.,...,. Cityor Town of: , L.{L• To the Inspector of Wires: By this application the undersign-. ; yes notteg of his or her ntention to .erfortn the electrical work described below. Location(Street&N ger A �`" p Lki �� _ Owner'or Tenant �� Owner's Address ' �� _A �`0., Telephone No. • • �i�; ' Is this permit in conjunction with a building permit? Yes No Purpose of Building [) .A..)-e_,\..\. (Check Appropriate Box) Utility Authorization No. Existing Service Amps ; / Volts Overhead 0 Undgrd New Service g 0 No.of Meters Amps / Volts Overhead 0 Undgrd 0 No.of Meters _r__ Number of Feeders and Ampacity L•o n and Nature of Proposed Electrical Work: k f __ "�`of • & ' • �J k r 11. ((APT uCompletion of thefollowin_ table may be waived by the I for of Wires. No.of Recessed Luminaires No.of Cell.-Soap.(Paddle)Fans No.of t Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming PoolAbove, ❑ rod ❑ Battery Units Lignttng • No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners o.of Detection and • No.of Ranges Initiating Devices Na.of Air Cond. Tonsl No.of Alerting Devices • No.of Waste Disposers Heat7'ump�l�umts„r„I Tqn, ,,,,, KW No.of Self-Contained Totals• I """""”'"'" I,Detection/Alerting Devices No,of Dishwashers Space/Area Heating KW 'Local❑Municipal No.of Dryers • Connection ❑ �' r3' Heating Appliances Key Srecurity Systems:* `o.o �, No.of Devices or '• Heaters KW I.° u.o Data Wiring: Si: s Ballasts No.of Devices or E•uivalent • No.Hydromassage Bathtubs No.of Motors Total HP a ecotnmun en ons " r ng • OTHER: No.of Devices or Equivalent • Estimated Value o Bloc al Work: Attach additional detail{/'desired,or as required by the Inspector of Wires. • Work to Start; 3 (When required by municipal policy.) quested in accordance with MEC Rule 10,and INSURANCE CO ERAGE: Unlesswaived by the ons to be Qowner no permit for theerformance of electricalpen work may is the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The unless undersigned certifies that such eo erage is in force,and has exhibited proof of same to the permit issuing office, CHECK ONE; INSURANCI BOND 0 OTHER 0 eoi I cert(fy,at _w-�-- --..._..... •+� .... a ....... (Sp fY�) FIRM NAI WAYNE SCHMIDT -"au the information on this application is true and compld ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE LIC.NO.: , Licensee: � MAR8TONS MILLS MA 02648 Signature Aea/IA.. • Address; (508)428- '7471 1 LIC.NO.: T . *Per M.G,L.c. 147,s.57-61,security work requires Department of Public Safety S License; Bus.L el.e. o. �•r , ��I „ „ Alt.Tel.No„ + ctio OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance Covera a no required by law. By my signature below,I hereby waive this requirement I am the(check one .$ owner Owner/Agenteq g anally Signature Owner's a:Lt. Telephone No. PERMIT FEE:$