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Home My WebLink AboutBLDE-23-000438 .1, Commonwealth of Official Use Only 4'41 Massachusetts Permit No. BLDE-23-000438 a...' 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:7/27/2022 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) 32 KATES PATH VILLAGE Owner or Tenant FITZGERALD ELAINE M Telephone No. Owner's Address 32 KATES PATH, YARMOUTH PORT, MA 02675-1448 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- I: 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 Initiating Devices No.of Ranges No.of Air Cond. 1 To No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent 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 Eauivalent 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 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 ckG___ . -ee,-. 5° . comnonwaa� o yyj n=;=.- a ///a�aachusaffa Official Use Only -'o Aparimant ol.} Permit No.� `3 -' / girt'sarvica9 • '= Occupancy and Fee Checked :>-:-f/ BOARD OF FIRE PREVENTION REGULATIONS {Rev. 1/07) • (leave blank) APPLICATION FORPERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Cl., C),52 C 2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: — City or Town of: YARMOUTH To the Inspector of Wires: By this application the Eindersign d ives noti e f his or her int lion to perform the electrical work described below. Location(Street&Number) \ v • Owner or Tenant t`ik � � � Telephone No. Owner's Address l:-:-. Is this permit in conjunction with a building permit? Yes ❑� No10 (Check Appropriate Box) � Purpose of Building \n5 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 • Ltio and Nature of Proposed Electrical Work: - on -T y'—,�`�3 fj)r N Ih"e ems'}— 0 S 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 - grad. amid. 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 t. Initiating Devices Tota No.of Ranges No.of Air Cond. To sl No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No,of Self-Contained - Totals:l` �`� - -�'-- Detection/Alertinu Devices No.of Dishwashers Space/Area Heating KW' Local❑ Municipal _ Connections No.of Dryers Heating Appliances Kam, Security Systems:* No.of Water No.of No.of No.of Devices or Equivalent Heaters KW Wiring: Signs Ballasts No.of Devices or Equivalent No, Hydromassage Bathtubs INo.of Motors Total HP Telecommunications ommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired or as required by the Inspector of Wires. Estimated Valu f Ele Work �j (When required by municipal policy.) Work to Start: // Inspections 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 X BOND ElOTHER X(Specify:) WO CK s s �`"' l I certi , under t'----=--- ---'-----'�'.-- - -.- • Pe fy:) WAYNE SCHMIDT y,that the information on this icati n is true and complete �i�{36[ CCi FIRM NAME: ELECTRICIAN LIC.NO.: 222 WILLIMANTIC DRIVE Licensee: ----MARSTONS MILLS, MA 02648 ____ Signatur (If applicable, ente (508)428-7747 'ne.) LIC.NO.:—_ Address: Bus.Tel.No.: 2 I '7) `Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt Lie No.. ,-,l / — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner 0 owner's a enL 7 Owner/Agent dSignature Telephone No. PERMIT FEE: $