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Home My WebLink AboutBLDE-23-001568 Commonwealth of Official Use Only NI ,.� Massachusetts Permit No. BLDE-23-001568 E. 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:9/26/2022 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) 18 STRAWBERRY LN Owner or Tenant WILLIAMS BENJAMIN J JR TRS Telephone No. Owner's Address CIO ME&JOAN, 13 BIRCHWOOD LN, LINCOLN, MA 01773 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: Replace two split A/C's&wire one new split A/C. 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 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 ❑ 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 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 C)t,L) & cos r . frx.K. at#361 f" , c �j • 1 ,,,, . -" • ,,� ommonwea��y /�/asdac a Of:oIal Use On! f y, Zepartrr ens of gire Serviced Permit No. --�C �o BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Pee Checked [Rev, 1/071 leave blank —"'�'" APPLICATION:FOR PERMIT TO PERFORM ELECT All work to be performed in accordance with the assachusetts Electrical JORK ELECTRICAL PRINTINM o• � ( e • , Date: 2MaCity or Town of: ef`; •vi� i I To the rBY this application the undersign:: ves notice . neCtoY of WSres: • Location(Street&Number) h a or A er mention to perform the electrical work described below. Owner'or Tenant & .A. 6 • Owner's Address ' u Telephone No. f Is this permit in conjun tion with a buildin J Purpose of Balding g Permit? Yes ❑ No (Check Appropriate Box) Utility Au orixation No. ------------xisting Service Amps • / youtts Overhead Ne Servic ❑• Undgrd❑ No.of Meters — Servi Amps ..._..',_., -.., Number of Feeders and Ampacity El No.of Meters __ Location and Nature of Proposed Electrical WorksVolts Overhead 0 Undgrd J. Lk,V t v ,eck... - c Tote No.of Recessed Luminaires Com lesion o the o owin b e s or of r Tio.of Cell,-Susp.(Paddle)Fans • o,ores. " No.of Luminaire Outlets Transformers _ A No.of Hot Tubs Generators KVA ----� No.of Luminaires Swimming pool rn e ❑ " n- ❑ o.o mergency g t ing • No.of Receptacle Outlets rnd: Batter Units No.of Ott Burners FIRE ALARMS No.of Zones No.ofSwitches No.of Gas Burners o.o etec ion and No.of Ranges ota • Initiatin l Devices • No.of Air Cond. No.of Alerting Devices No.of Waste Disposers Tons ea um ;nm.,r ,...4ns "', �" `o.o e onta ne Totals ' ""'"' " Detection/Alertin_ Devices No.of Dishwashers • Space/Area Heating KW' " un c pa No.of Dryers I,oca!❑ Connetion ❑ Other Heating Appliances Kr ecur stemst o.o ater o,o No,of Devices or E•uivalent Heaters l{�'4' a•a Data Wiring: Sins Ballasts _ No.of Devices or E.trivalent • No.RYdromassage Bathtubs No.of Motors Total I•IP 7e ecommun cat ons BB-' ring: OTHER: ` No.of Devices or E B.uivalent UM_ 11111.STRE! EStimatod Value f c cal Workc Attac" additional detail if desired,or as required ay e Inspector of Wires. • Work to Start; (When required by municipal policy.) INSURANCE C E � Inspections to be requested in accordance with MEC Rule 10,and upon completion. RAGE: 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 CFIECK ONE: INSURANC BOND ❑ OTHER �,,) office, I certify,ea •- --»• - •''-4 .' '•-••-•"'tat the f Information on this application is true and complete,. FIRM NAI WAYNE SCHMIDT ELECTRICIANp Licensee: 222 WILLIMANTIC DRIVE J� Aill ILIC.NO.: �, C (Ifapplicabl� MARSTONS MILLS, MA 02648 Signature I1 r !, • Address: (S08)428.7747 LIC.NO.: *Per M,CI,L,c. 147,s,57-6I,security work requires Department of Public Safe S Vice Bus.Tel.No.: .ra#� OWNER'S INSURANCE WAIVER: Tam aware that the Licensee does notSafety License: Alt.Tel.No.: +' " 2t7 Lic,No. required by law. By my signature below,I hereby waive this requirement. I am the(check one . have the liability insurance coverage normally Owner/Agent Signature .0 owner ❑owner's a ent, Telephone No. PERMIT FRE $