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Home My WebLink AboutBLDE-22-003354 Commonwealth of official Use Only VIMMassachusetts Permit No. BLDE-22-003354 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:12/13/2021 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) 121 CAPT BACON RD Owner or Tenant MULHERN KEVIN J Telephone No. Owner's Address MULHERN MARY ANN, 121 CAPT BACON RD, 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: Miscellaneous work per attached. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil: No.of Total 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. 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 HeatingLocal ❑ Municipal No.of Dishwashers P KW Connection ❑ Other: 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. required Value of Electrical Work: (When q uired by municipal policy.) y' 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.No.: 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. I Owner/Agent I PERMIT FEE: $50.00 Signature Telephone No. C1(60 .....4.6_ rer-, . • A Commonwealth.o/Illaddachueettd • Official Use Only >,01 � cc77 Permit No. 1 —3j�j S e e l - y 2epartm ent oPire Serviced if Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. (leave blank) r APPLICATION. FOR PERMIT TO PER-FORM EL CTRICAL WORK All work to be performed in accordance with the assachusetts Electrical C fyi 5 12. (PLEASE NWT IN INK O L 0 ; d/ Date:City or Town of: .0 To th ore Inspe of Wires: • By this application the undersign v note of his or her ntention to perfo the electrical wworrk described below. Location(Street&Number) (a S, Owner-or Tenant Ke_,U in U Q i N j Telephone No. Owner's Address • ,jP'n.t. Is this permit in conjunction with a building permit? Yes 0 No W. (Check Appropriate Box) Purpose of Building Q �\.Q(`t Utility Authorization No. Existing Service Amps • / Volts Overhead ❑, Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity MLocation and Nature of Proposed Electrical Work: I " , , t Li - N C . os. .. Completion of the following table m be waived 1y the Ins,ector of Wires. 145 No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of Total . Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.• of Luminaires SwimmingPool Above In- No.of Emergency Lighting • Ernd. ❑ grnd. ❑ B Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of'Switches No.of Gas Burners No.ofbetection and Initiating Devices No.of Ranges No.of Air Cond. Ton .No.of Alerting Devices • No.of Waste Disposers Heat Pump Number Tops„„„,KW„„•,„ No.of Self-Contained Totals: Detection/Alerting Devices . No.of Dishwashers • Space/Area Heating KW' Local 0 Municipal 0 fie, . 'Connection No.of Dryers Heating Appliances KWSecurity Systems:* No. f Devices or Equivalent No.of Water ��`a'Kam, 'No.of No.of Data Wiring: Heaters Sins Ballasts No.of Devices or Equivalent • No.Hydromassage Bathtubs INO.of Motors Total HP Telecommunications Wiring: _\\\ ��\ �`r►„ No.of Devices or Equivalent OTHER: We,N f, . Attach ditional detail l/'desired,or as required by the Inspector of Wires. • Estimated Value nof lectricnal Work: (When required by municipal policy.) Work to Start: IO.\`\ Q-A 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 ElOTHER 0 (Specify:) I certify,at — -- '" �' ''-- -"Wit the information on this application is true and comple 1 WAYNE SCHMIDT .53c FIRM NAI ELECTRICIAN � axa- LIC.NO.: Licensee: M 222 WILLIMANTIC DRIVE Signature�\iv LIC.NO.: (Ifapplicabl� ARSTONS MILLS, MA 02648 • Address: (508)428-7747 Bus.Tel.No.h "'7 `fr7/ Alt.Tel.No.. ll,.i f /t . *Per M.O.L.c, 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.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).0 owner CI owner's a ent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ 5