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Home My WebLink AboutBLDE-23-000476 6Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-000476 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:7/29/2022 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) 72 KATES PATH VILLAGE Owner or Tenant Alexandra Wynkoop Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ 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 water heater 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. To 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 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water 1 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 ❑ 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: $50.00 q ,�- I) gII/2 l -Pal 1-/A) feta. 60' 397-- , • r Commonweanh o f Maeaachadett� . /� c� Official Use Only `' Ze artment o Serviced Permit No. • , ,, Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS APPLICATION.:FOR PERMIT TO p [Rev, I/o7J leaveblanic ---- 4 Al!work to be performed in accordance with the as$ RPhusetts®� ELECTRICAL WORK (PLEASEPRXNTININIK'O' r 2.-- , 27 CMR t2.00 City or Town of: ,��;�` o��i� Date: 2 By this application the undersign • ves n.t e o To the Inspector of Wires; • Location(Street&Number) r//A his or her nt ;�,. perform the leo al work described below, • Owner'or Tenant "�-es 4/ � �� • ,Oe Owner's Address , r � �, g Telephone No. '� • Is this permit in conjunction with a tdln Purpose of Building t;permit? Yes ❑ No (Check Appropriate Box) Existing Service Utility Authorization No, Amps • / Volts Overhead O. Undgrd 0 No.of Meters - -_ Se Amps - -/ ---� -YeIts Overhead Number of Feeders and Ampacity Undgrd No.of Meters Location and Nature of Pro o d Electrical Woek: No,of Recessed Luminaires Com lesion o the ollowin table ma be waived b the Ins ector o Wires No,of Cell•-Soap.(Paddle)Fans o.o No,of Luminaire Outlets Transformers KVA No.of Hot Tubs• Flo.of Luminaires Generators KVA Swimming Pool rug e ❑ n- o. mergency g 1 ng No.of Receptacle Outlets nd' ❑ Battoer Units No.of OH Burners FIRE ALARMS No,of Zones No.of'Switches No.of Gas Burners o.o e ec on an No.of Ranges ota Initiatin Devices No.of Air Cond. No.of Alerting Devices • No.of Waste Disposers Tons `eat'ump � , . ,, Totals: °qg.•,,.•,.•„,. .. o.a e - on a ne No,of Dishwashers • Detection/Alertin! Devices Space/Area Heating KW' Local[]. Tun c pa No.of Dryers Heating Appliances ecurt Connection El Other o.o ater KWystems. Heaters KW o•o No,of Devices or E uivalent Si ns BallastsData Wiring: No.of Devices or E uivalent • No.Hydromassage Bathtubs No.of Motors Total HP Te ecommuntcat ons rr ngg: OTHER: No.of Devices or E uivalent E�tnnated Value of lee foal Work: Attach additional detail red,or as required by the Inspector of Wires. • (When required by municipal policy.) Work to Start; �ZZ INSURANCE 0 Inspections to be requested in accordance with MEC Rule 10,and upon completion. GEo 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. undersigned certifies that such co erase is in force,and has exhibited proof of same to the permit issuing office, CHECK ONE: INSURANCq t• The I cert6 ur -. I N --•..__.. -• ..BOND 0 OTHER. 0 (Specify:) FIRM NAI WAYNE SCHMIDT W- n at the information on this application is true and complete. ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE T;IC.NO.: ( applicably MARSTONS MILLS, MA 02648 Signature • Address: (508)428.7747 - ..._. LTC.NO.: *per M.G�L,c, 147,s.57-6I,security work requires Department of public Safety"S"License: Tel.No.: � d OW OWNER'S INSURANCE WAIVER: Tam aware that the Licensee does not haveAlt.Tel.No.: v•"� lid e• Lin.No. required by law, By my signature below,I hereby waive this requirement. I am the(check one. ownercoverage normally Owner/Agent AI 41IP Signature0 owner'. :•ent Telephone No. PERMIT FEE:$