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Home My WebLink AboutBLDE-22-003962 04 Commonwealth of Official Use Only 4. ,t " Massachusetts Permit No. BLDE-22-003962 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:1/18/2022 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) 80 BAXTER AVE Owner or Tenant Neal Checka Telephone No. Owner's Address 80 BAXTER AVE,WEST YARMOUTH, MA 02673 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: Split NC&receptacles 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 2 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 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 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 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. I PERMIT FEE: $50.00 Qj S 41 - gr. ), 4 \ d 35I6 • • Commonwealth o/ dahge f, Official Use Only sj' ' 2epartment ol.y`ire Services Permit No. 22 �j� r y w `' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Pee Checked [Rev. 1/07] (leave blank) APPLICATION. FOR PERMIT TO PER-FORM ELECTRICAL WORK All work to be performed in accordance with the assachusetts Electrical me r r R^ (PLEASE PRINT IN INK O• If; L • • ;jellI Date: s, l2,00 City or Town of: AIL( v By this application the undersi: ve ti a of AI` To the Inspector of Wires: her her ent'Ji, to performt Ltd/ electrical work described below. ;7g� Location(Street&Number) . • �- 'e `-td �1'G Owner'or Tenant 1111[1. Owner's Address ' Telephone No. AIM Is this permit in conjun do with a b t ing permit? Yes Purpose of Building ❑ No (Check Appropriate Box) Unlit r-Authori ti W% Existing Service Amps p • / Volts Overhead J. Undgrd Now Servic- g ❑ No.of Meters _ ew Sery ce Amps / Volts Overhead[] rd_ • Undg, 0 No.of Meters ) `i-C if 1 mnimmys L.h--ito •lion and N re of Proposed Electrical Work: r a d �` ( � r Com lelon o the ollowin table ma be waived b the Ins ector o Wires; No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans o•o KVA No.of Luminaire Outlets Transformers No.of Hot Tubs Generators KVA • No,of Luminaires Swimming Pool o e n` o.o mergency g g • rnd. nd: ❑ Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No,of Zones No.of Switches No.of Gas Burners o.o e ec on an • No.of Ranges of Initiatln Devices • No,of Afr Cond. Tons No.of Alerting Devices No.of Waste Disposers 'eat `ump ` ens r Totals: -„•: .,».- o•o e - on a ne No.of Dishwashers ~. Detection/AlerHn: Devices Space/Area Heating KW' Local `u c pa No.of Dryers 0 Connection ❑ �' i y Heating Appliances Rey ecur ys ems: o.o ater Kw o.o o•o No.of Devices or E uivalent Heaters o ns Ballasts Data Wiring: No.Bydromassa a Bathtubs No.of Devices or E uivalent • Total HP •eiecommun cations r n : No,of M ors g OTHER: No.of Devices or E.uivalent tt '� �' Gi�� -.-l• AO er��A Scrn it • Estimated Valu f Ele 'c Work: Attach additional detail f'desired,or as required by the Inspector o (When required by municipal policy.) f Wires.�� Work to Start: • Inspections to be requested in accordance with MEC Rule 10,and upon completion. kOe INSURANCE VERAGE: 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 ElO•HER 0 (Specify:) I certify,ea _._ _._,_.. .. �_ ... . FIRM NAI WAYNE SCHMIDT gat the information on this application is true and complete ELECTRICIAN I. ,,al IiIC.NO.' Licensee: 222 WILLIMANTIC DRIVE P (Ifappltcabl� MARSTONS MILLS, MA 02648 Signature Zrr' 'ti....OMF • Address; (508)428-7747 LIC.NO.: Bus.Tel.No.. w,,'. dim, 117/ *Per M.G.L.c, 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. Alt,Tel.No.. r�i�r OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance covers a normal e law. By my•signature below,I hereby waive this requirement. I am the(check one .❑owner dOwner/Agent $ ly Signature ❑owner's a ent, Telephone No. fji1iT FEE:$