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Home My WebLink AboutBLDE-22-000542 Commonwealth of Official Use Only 1. ,�+ Massachusetts Permit No. BLDE-22-000542 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:7/30/2021 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) 9 BELLE OF THE WEST RD Owner or Tenant EVANS KENNETH M Telephone No. Owner's Address EVANS CHRISTINA L, 9 BELLE OF THE WEST RD,YARMOUTH PORT, MA 02675 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: Replacement HVAC. 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. 1 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 0 Municipal 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 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 ❑ (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 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 fe,...5) 00-___.- i ,, Commonwealth of//lassac edei Official Use Only Pl _==- mot i >;�►- c� O = 11�= = Apartment [3. S Permit No. `—(�Z— I. . o cra Serviced =`- ' 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 Code 5 111.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ! City or Town of: YARMOUTH To the In pe for of ires: By this application the undersign gives notice o his or h ' tension to perform a lectrical work described below. Location(Street&Nu ber) le �q� • Owner.or [ �Tenant /\e A k `n r 1 Telephone NoG i 1 - Owner's Address S 1 L Is this permit in conjunction with a bu permit? Yes i)ding C� � ❑ No (Check Appropriate Box) Purpose of Building D VV \�f tna_s Utility Authorization No. Existing Service Amps / Volts Overhead 0. Undgrd t; ❑ No,of Meters New Service Amps / Volts Overhead❑ Und rd g 0 No.of Meters Number of Feeders and Ampacity • Lo tion and Natiure of Proposed Electrical Work: rkS ((��= ,1° Iv -e-ems �,t► -P.ep cee____— ComplVtion of the following tab a 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.tof Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.01,L mergency Lighting • grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.of Zones .00 No.of Switches No.of Gas Burners � '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 I Numb __pus_ KW No.of Self-Contained Totals: -`�"" Detection/Alerting,Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection El other v No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of Heaters KWNo.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: I No.of Devices or Equivalent • Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value E. ctri al Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VERAGE: 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 Ii< BOND 0 OTHER S ci (WO C" ' 1 1 certify, under t'-- ----- --- - rm n o WO�� FIRM NAME: WAYNE SCHMIDT y,that the information on this ,, icati n is true and complete. ELECTRICIAN LIC.NO.• � Licensee: 222 WILLIMANTIC DRIVE - �_ (If MARSTONS MILLS, MA 02648_Stgnatu LIC.NO.: Address:applicable,Ante (508)428-7747 ne.) __________ Bus.Tel.No.: 02' *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safe Alt.Tel.No.: ___I / OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below, I hereby waive this requirement. I am the(check one ❑owner o Owner/Agent — ❑owner's a nt Signature �I Telephone No. PERMIT FEE: $