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Home My WebLink AboutBLDE-22-005993 Commonwealth of Official Use Only t, , -197 ,� C-X Massachusetts Permit No. BLDE-22-005993 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:4/19/2022 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) 111 PHYLLIS DR Owner or Tenant Rob Sequin Telephone No. Owner's Address 111 PHYLLIS DR, SOUTH YARMOUTH, MA 02664-1647 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service&install lights. 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 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 No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 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 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 6 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 • 1 p'Ar . Commonwealth o/Va�eackwatti OtYicial Use Onl te(1i yl .Uepartment ol.7•ire Serviced Permit No. '�`�-r !�3 C I I _ tij7 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. I/071 (leave blank) _ APPLICATION. FOR PERMIT TO PERFORM ELECTRICAL WORKAll work to be performed in accordance with the assachusetts Electrical (PLEASE PRINT ININIC'O' r A r# r • If'er, Date: ' yt12.00 City or Town of: ('� •v � ' By this application or the undersign i To the I Spector of Wires: gn ves noof h or er mention to perform the electrical work described below. Location(Street& ► , her) I. ` �' Owner'or Tenant 1j �=11% �� `"� Owner's Adt(ress Telephone No. al • • Is this permit in conju ton with building , Purpose of Building ` permit? Yes 0 No (Check Appropriate Box) Utility• uthortzatirnt No. ExistingService Amps ,...Volts Overhead �--t o Se ce ❑. Undgrd 0No.of Meters Amps i__f Volts Overhead`I Undgrd 0 No.of Number of Feeders and Ampacity t "" MetersAl__ kill.•ocation and Na`nr, of Proposed Ele scat Work:`r /' TT III�'% . �� , MfainInAWakic. or S . . Com'letlon o the ollow table In, be waived 1 the Inspector o Wires; No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans ota o.o No.of Lurninatre Outlets Transformers KVA No.of Hot Tubs Generators KVA ' No.of Luminaires Swimming Pool _r'o e L.."' n- ❑ .o Units cy g ng No.of Receptacle Outlets n�' Batter Units No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners `o.o e ec`an an No.of Ranges Initiatin Devi es No.of Air Cond. eta No.of Alerting Devices • No.of Waste Disposers Tons 'eat 'ump '' E ons ' ' ' `o.o e - on a ne' Totals: "" "^� "'�i Detection/_Alertin. Devices No.of Dishwashers • Space/Area Heating KW' Localp Q Ync a No.of Dryers - _C_ sun:ection 0 fie' ry Heating Appliances K VV ecur s ems: o,o ��a er No.of Devices or E E uivalent Heaters KW o.o o.o Data Wiring: Silvis Ballasts No.of Devices or E.uivalent • No.Hydromassage-1 athtubs No,of Motors Total HP •[ecommun ea ons v r ng: OTHER: No.of Devices or E E uivalent • Estimated Valli o gctrl a,} Work: Attach additional detail U'desired.or as required by the Inspector of Wires. • Work to Start; L J�Z (When required by municipal policy.) INSURANCE C Inspections to be requested in accordance with MEC Rule 10,and upon completion. • RA E: 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: INSURANC BOND 0 OTHER egret, -- ._ _ 0 (Specify:) I cer FIRM NA! WAYNE SCHMIDT -"tat the information on this application is true and complete ELECTRICIAN 1 LAC.NO,: c ct (Ifappsee: MARSTONS IMA 02648 Signature ,/,C,,,,, ,� °of applicabli (508)4 MILLS, M 7 LIC.NO.; • Address: Bus.Tel.No.: ti►r, ' if it*Per M.6,L„cE 147,a.57-6I,security work requires Department of Public Safe S Alt.Tel.No., a 4...p_7 2(7/ OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage Lic,No, required by law. By my signature below,I hereby waive this requirement. I am the(check one .I owner g normally Owner/Agent Signature ❑owner's a.ent, Telephone No. PERM3T FEE:$ ilif.