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Home My WebLink AboutBLDE-23-001055 of Commonwealth of Official Use Only E' i Massachusetts Permit No. BLDE-23-001055 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:8/29/2022 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) 41 GOLFERS CIR Owner or Tenant FRENCH JOHN B Telephone No. Owner's Address 41 GOLFERS CIR, 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 air handler(Attic)and condenser. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 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 Initiating 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/Alerting Devices Space/Area HeatingKW Local ❑ Municipal 0 Other: No.of Dishwashers P Connection HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 LIC.NO.: 33699 Licensee: Wayne B Schmidt Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.N Address:222 WILLIMANTIC DR, MARSTONS MLS MA 026481929 *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 I PERMIT FEE: $50.00 I Signature Telephone No. fiX.,-- ' 0.. . Cit!...1 4.b 5' , Co�nmnwea°tiof/ asac� �6 Official Use Onty, r 'ri -Uepartment o/glre�ervicea Permit No. �� 55 • _..1 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked b ''.r »PN (Rev. 1/07j (leave blank) APPLICATION.:FOR PERMIT TO PERFORM E ECTRICAL All work to be performed in accordance with the assachusetts Electrical C • 1.C),l2 ? :.l2.00vvORK (PLEASE PRINT IN INK O' '' ' ;t I., , ' , I Date: 0s `� City or Town of: r •v 0 To the Inspector of Wires: . By this application the undersig• :eves 4ot ce of or her ntention to performhe a work tr caldescribed below. Location(Street&Number) i his CAccA c 5 . • Owner'or Tenant bbb Telephone No. Owner's Address Is this permit in conju on with a tiding permit? Yes No . El of Building � � (Check Appropriate Box) J , Utility A thoriz tinq No. - Existing Service Amps •• / Volts Overhead ❑. Undgrd 0 No.of Meters Now Service Amps ,. I Volts Q head❑ Undgrd Number of Feeders and Ampacity El No,of Meters • Location d Na a of Pro osed E etrical Work: • law rJ,� n h'1 (. 6 Completion o the ollowin table ma be waived b the Ins ector of Wires.No.of Recessed Luminaires No,of Ce91,-Susp.(Paddle)Fans • o.o ofNo. • u inaire Outlets Transformers � KVA No.of Hot Tubs Generators KVA • No.of Luminaires Swimming Pool Abover ❑ In- 0 $a_ottery Emergency Lighting • No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones • No.of Switches No.of Gas Burners No.of Detection and No.of Ranges Total Initiating Devices • No,of Air Cond. Tons .No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tod W No.of Self-Contained Totals: }'"''"' Detection/Alerting Devices No,of Dishwashers Space/Area Heating KW Local Municipal ❑'Connection ❑ Other No,of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No,of Data Wiring: 1 Signs _ Ballasts No.of Devices or Equivalent • No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring; OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires. • Estimated Value o Elec cnal Worki (When required by municipal policy.) Work to Start: 'J 2� ,/4...- 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 co erage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER. 0 (Specify:) I certifj?,ur '... —• '"• ' -•'"''tat the in f ormation on this application is true and cornplete. WAYNE SCHMIDT FIRM NAI Pp ELECTRICIAN 4 LIC.NO.: �1 Licensee: 222 MILLS, DRIVE6 Signature, (Ifapplicabl� MARSTONSWILMILLS, MA 02648 • LIC.NO.: • Address: (508)428-7747 Bus.Tel.No,: ofa *Per M.O.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.LT e.No. + ��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 agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$Ct;V 1