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Home My WebLink AboutBLDE-21-006202 Commonwealth of Official Use Only E` Massachusetts Permit No. BLDE-21-006202 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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:4/27/2021 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) 62 DIANE AVE Owner or Tenant Marianne Grenon Telephone No. Owner's Address 62 DIANE AVE,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 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- ElNo.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 Initiating Devices No.of Ranges No.of Air Cond. 1 Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 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 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 &S 5/977)2 e,_ CK(i-'1:: _a___. rTeg,e-- 60 . Comrnonwsa[th of Massac (ts ,•• Official Use Only y �` / 4 4' �! Permit No. 2eparimani of gire Services -iOccupancy and Fee Checked • BOARD OF ARE 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 CodT22_ C),527 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: f-1 City or Town of: YARMOUTH To the Inspector of Wires: By this application the tmdersigne ' noti e of his or her intention to perform the electrical work described below. Location(Street&Number) Ct Ownner'or Tenant A-Ck t.L Y11�� • it - (./ Telephone No, a — Owner's Address . - L! Is this permit'in conjunction with a bui ding permit? Yes ❑ No )16 Purpose of Building ��` : •••• (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead ❑. Undgrd❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ NO.of Meters Number of Feeders and Ampacity — Lo tionnanddNature of Proposed Electrical Work: • 1 S ?u r i J A- .4- 1Y\ ,.. � • Completion of the followin&table may be waived by the Inspector o Wires, No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total KVA No.of Luminaire OutletsTransformers No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No,of l!mergencynghting grnd., grad.• LI Battery Units • No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No,of Switches CNo,of Gas Burners~ No.of Detection and ' Initiating No.of Ranges Tota I iq1,-, Devices - • No.of Air Cond. Tons 04,I'--No.of Alerting Devices No.of Waste Disposers Heat Pump Numb r Tons KW No.of Self-Contained • Totals "}"""-"'" ""-"`"" Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW' Local❑ Municipal - - Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW Na.of Data Wiring: Signs Ballasts No•of Devices or E uivalent No.Hydromassage Bathtubs INo.of Motors _ Total HP Teleco of De c Devices or Equivalent OTHER: No.of Dee Equivalent Work �Estimated Val Attach additional detail if desirea or as required by the Inspector of Wires. u�°f�E je�tnc i� (Whet}required by municipal policy.) Work to Start:tY1r9►t r'[`� pections to be requested in accordance with MEC Rule 10,and upon 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 X BOND 0 OTHER ( Jo cKe I certrfy, under t'-------- - _---_ -- -,- S Peci fy) FIRM NAME: WAYNE SCHMIDT 7,that the information on this icatt n is true and complete. ELECTRICIAN 1 LIC.NO.: i. Licensee: 222 WILLIMANTIC DRIVE „to —MARSTONS MILLS, MA 02648_- Signatu LIC.NO.: (If applicable, elite (508)428-7747 .ne.) �_ Address: Sus.TTee N �o. '71 _i *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt L,ic.�No — OWNER'S INSURANCE WAIVER: I 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 0 owner 0 owner' a ent. Owner/Agent i Signature Telephone No. PERMIT FEE: S t