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Home My WebLink AboutBLDE-22-003028 • o ", Commonwealth of Official Use Only E` ! Massachusetts Permit No. BLDE-22-003028 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:11/24/2021 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) 25 TAM-O-SHANTER WAY Owner or Tenant Alan Fairweather Telephone No. Owner's Address 25 TAM-O-SHANTER WAY, 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: Wiring for add on NC condenser. 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 g bovernd. 0 grid. ❑ No.of Emergency Lighting 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 Ton 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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.te of KW No.of No.of Ballasts Data Wiring: 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 LI NO.: 33699 (If applicable,enter"exempt"in the license number line.) Bus.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: Alt.Tel.No.: 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. bk: I PERMIT FEE: $50.00 , -'-.. , 2-0 f 24 Z F. 00 6602:4c5.5 A, C r//addaca6 • " Aft it ccor�m nw� ° c7 Official Use Only t el `' Zepartment ol...ire S ��--� II -;" Serviced Permit No. w' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Pee Checked APPLICATION. FOR PERMIT TOP ' � �R�'' lio7J leave blank — All work to be performed in accordance with the assa h tt FORM ELECTRICAL WORK (PLEASE PRINT IN INK 0• r h' L , a . 1 ) 27 CMR 12.ao City or Town of: �f1�., v �' Date: res: By this application or the undersi:..: _,vas noI t� To the Ins ector o ce of his or her nten' n to perform the electrical of de bed below. • Location(Street&Number) Gam '& .- ,y S° Owner'or Tenant ,�a, 6ti `�� `'� �_ Owner's Address .. rIL Telephone No. • Is this permit in conjunction with a building permits. yes . Purpose of Building ❑ NO ❑ (Check Appropriate Box) Existing Service Amps • / Utility Authorization No. ..._. Volts Overhead ❑• Undgrd❑ No.of Meters _ Mexican Amps / Number of Feeders and Ampaci ——Volts Overhead ElUndgrd 0No,of Meters Lon nand Nature of Proposed Electrical Work: �P war;p:ow-.►' ;av F No.of Recessed Luminaires Com,lesion o the ollowin. table ma be waived 1 the lns•ector o Wires No.of Cell.-Susp.(Paddle)Fans -'o,o' No.of Larninatre Outlets Transformers KVA • No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool _ode ❑ n` ❑ 'Battero.o Units mergency g ng No.of Receptacle Outlets � nd Units No.of Oil Burners FIRE ALARMS No.of Zones `o.o Leec on an. • No,of"Switches No.of Gas Burners No.of Ranges Initfatln Devices No.of Air Cond. o No.of Alerting Devices No.of Waste Disposers Tons `eat'ump ons r, Totals: - o,o e - on a'ne No.of Dishwashers -- - Detection/Alertin. Devices Space/Area Heating KW No.of Dryers 'Local❑.Connection 0 Other Heating Appliances KW ecur ys ems: o.o "star ,o.o No.of Devices or E.uivalent Heaters KW O.o Data Wiring: No.Hydro massage a Bathtubs Sins Ballasts No.of Devices or Equivalent • No,of Motors Total HP i e ecommun cat:o r E Wiling: OTHER: No.of Devices or E uivalent Estimated Value of 1 orki Attach additional detail tides:red or as required by the Inspector of Wires. • Work to Start; (When required by municipal policy.) SURANCE CO 4- Inspections to be requested in accordance with MEC Rule 10,and upon completion. INnless 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 e undersigned certifies that such co erage is in force,and has exhibited proof of same to the permit issuingoffice. CHECK ONE: INSURANCequivalent, The I certify,al ----- .BOND 0 OTHER 0 (Specify) FIRM NAI WAYNE SCHMIDT • _. 'tat the information on this application is true and complete ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE !AC.NO.: MARSTONS MILLS, MA 02648 Signature 1 r RfaPPltcabl� (508)428-7747j' '- LIC.NO.: • Address: *Per M.D.L.c. 147,s.57-61,security work requires Department of Public Safe Bus.Tel.No.. ace OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have Alt.Tel.No.. w +sf �i 1 Safety S License: Lin. c �`� ��+ e y law. By my•signature below,I hereby waive this requirement. Iam the one .■ owner , Owner/Agentd (check liability insurance coverage normally Signature ❑owner's a:ent. Telephone No. PERMIT FEB:$ 5