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Home My WebLink AboutBLDE-22-001113 (' P Commonwealth of Official Use NI% Massachusetts Permit No. BLDE-22-001113 c 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:8/27/2021 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) 20 MATTIS DR Owner or Tenant BASKIN LAUREN Telephone No. Owner's Address COLANGIONE LYNN, 20 MATTIS DR,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: Upgrade/replace exterior service equipment&grounding. 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 4 No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units n1 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 0 No.of Ranges No.of Air Cond. To No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices 7 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 Ballasts Data Wiring: Heaters Signs 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 ❑ 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 my signature below,I hereby waive this requirement.I am the(check one) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 qg, 45-17.4 - ft Q 14:2,i ..,.....— ret. .' Cli<&"left,c ••• . k (/_.I ' n �-' r� `�a ndRt(/fa el vlQdeQClfff.7fiW ei 1( aParfi+jo ol .,�arvkae permit No. Y `` ;,, BOARD OF FIRE PREVENTION REGULATIONS Occupancy and pee Checked APPLICATION �'OR;PERMIT TO • save blank """`- All work to beperfarntex!tnacc PERFORM EL�CTRlCaL, (PLEASE PRINT 1N INK OR TYPE A ice with the Massachusetts Electrical C x, WD R K City or pro ��pUT�I'� Date: x.�a By this application thou Of; R� �'rtd ., d es no ce of h s or er intention to . To the Inspector of work res. . Location(Street&Number) i ''Y� dorm the electrical described below. Owner'or Tenant L'- U t twit _ V.� . Owner's Address %a �iyt- Airlf Is this permit in conjuncHoniwith a bu dt � .•• Telephone No._�!` S' Purpose r Build �� g permit'? Yes +, No .4 (Check Appro Service jiy Amps / Uttifty Authorization No. eis Existingn'tSe t �� Volts Overhead; Und rd' ----._.. Amps �1V g 0 No.of Meters Number of Feeders and Asnpacity "Valts Overhead[,� Undgrd Pl'eferQ*--- Lo tiop and Natiure o Prows,, B 0 Nti.of Meters eatrica!Workt ♦ ( 0 1!'EJQ No,of Recessed Luminaires Coln Alton• t�- ollowi : ��'�•�r`-�,lrl.! No.of Ceu.-Spsp.(Paddle)Fans • table tn. be waived• the has, �r ,r No.of Lutnlnaire `o.o actor o Wires, Outlets No.of Hot Tubs GTenerators ' -rs KVA No,of Luminaires Generators Swhumfng Pool m de n. KVA No.of Receptacle Outlets d. Bette 'merge' M g ng • No.of Switches Na.of Of!Burners Units FEiURI No.of Ranges o.`Lid' ► t:c o�an Na of Air Card `L itlat3n= • No.of Waste Disposers ea a Devvi Tans No,of Alerting Devices T'tills: .um a �. No.of Dishwashers Doo �®n a ne No.of SpacMArea Heating KW Luca! 'u pabevtc� `tsars HeatingKW ecu Cevi action ❑Other 1o•o. "a or Appliances y Heaters KW o.o `o.o N .of Ds ems: evfces or B.ulvalent No.Nydromassage Bathtubs Sins Ballasts oats Firing: Na.of Motors No.of Devices or E.uivalent OTHER: Total Hp c eco of De cat ons gg;: No.of Devices or �•ul dent Estimated Value of Et Attach addition?!detail(f d�lred or as required Work Slant 'cal Work: INSURANCE (Whorl required by municipal policy,) by the Inspector of Wires. COVERAGE: inspections to be requested is accordance with the licensee provides ' Unless waived bC Rule 10,and upon completion, undersigned certifies R proof : Unless in y the owned',no permit for the erfo �' Vance includin " p rmattce or electrical work ui CHECK ONIr, $ �mpiete.•d operation"coverage may issue unless r HEM, ' INSURANCEBO is in force d has cxhibltcd proof of samc to the its substantial equivalent. The a r ti'- lY, nde •.._ __ .,�.� . x(St?�ify;) permit issuing office, FIRMcaNAME: WAYNE SCHMIDT '�•"'9,that the 1 ELECTRICIAN Inform on an th `� Licensee: 222 WILLIMANTIC DRIVt» c n is hue and c mpleta (1fapplicable, MARS'rON$ MILLS MA 0264 Signals NO.: Address; (608)42g,�j747 en.�. LIC. J 'Per M.CI.L.c, 147,s.S LIC.NO.: OWNER'S Iv1. 'S INSURANCE 14 7-61,security work requires De sus.Tel.No.. a,,""`; required by law. RA.NC>w WAIVER: i am a partttlent of public Safety Alt.Tel.No.; :Ili r�l a Owner/Agent ant '' that the Licensee does not have ,f liability Lin,No, By my signature below,I hereby waive the liability insurance covera'e I �`' Signature this requirement. I am the ..Telephone No. (check one owner owner's Daily —~ PI RM'IT F'PM a nt