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Home My WebLink AboutBLDE-22-002079 or:-‘ Commonwealth of Official Use Only . , Massachusetts Permit No. BLDE-22-002079 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:10/12/2021 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) 22 HARVARD ST Owner or Tenant CALLINI JOHN A Telephone No. Owner's Address CALLINI JOAN E,40 LINE ST, SOUTHAMPTON, MA 01073 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check A iateox) Purpose of Building Utility Authorization No.(iii‘?Ko. Existing Service Amps Volts Overhead ❑ Undgrd ❑ 1Y11kters, New Service Amps Volts Overhead ❑ Undgrd ❑ 0tf Number of Feeders and Ampacity .�•-> � a : yyr "w.i� 's: u , ) Location and Nature of Proposed Electrical Work: Add on Air Conditioner&GFI receptacle. f// / ,, ,, ,/ Completion of the following table may az b 1h,1 -ctor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of AI' ,:1 Transformers A No.of Luminaire Outlets No.of Hot Tubs Generators 3 KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 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/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 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 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 Nitylk tO/ v K %- if(c 2z- . Fec • ,.. ) , clurn.%,-. 0/ • �otnirwrrwea of u s ii/aasachttsal '��t...,: �0 8 86 ORI Ell t� t` :y .1JaP ,�al fr.,sarvlaia permit No. � '� , ,,,.' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Pee Checked APPLICATION �QR�P��NtIT TO p �►. Iro71 � pave blank '---- A!!work o be porfbrmtd in accordance with the MassachusettsPERFORM �(�p R K (PLEAS' PRINT IN INK OR TYPE ALL INFOR4L4TI )' Cif 12.00 City or Town of: QUT � Date: . By this application the�rrrdor�sl d vas ni To the Inspector of PYires: Location e° h s°lr h ate lion to perform the electrical work described below. (Street&?Number) Owner'or Tenon n1 Owner's Address Telephone No. Is this permit In corrfunetion with a u ding permit? Yes ❑ No ('Check Appropriate Box) Purpose of Building Existing Service A Utility Authorization No, Amps / Volts Overhead g rd ,a Amps / 0 Undgrd❑ No,of Meters _ Number of Feeders and Ampact Volts Overhead❑ Undgrd 0 Na,of Meters Lotfo and store o Pro • - '-""'------ d Electrical o+ r�jc:, r K„_)___W O A it- r Z.of Recessed Lurrsiasfres Con•letion • the allows : table m- be waived• the in sectar a Wires, No.of Ceti.-Soap.(Paddle)Fans ,o.o` No,of Lurninafre Outlets Transfo •ors ICVA No,of Lunrinalres No.'of Hot Tubs • Generators KVA Swh swing Pool rid 0 0 a- No.of Receptacle Outlets d• 8a m a g °g • No.of OR Burners No,of SwitchesF AL�1.ttM3 No.of Zones No.of Ranges I" I`o.o' t- ec;ahran, Na of Air Cond Iaftlat;n_ Devices • a• No.of Waste Disposers `ea nip Tans Na.of Alerting Devices p `um.et, arts . 1-1 No.of Dishwashers T. ale' on ` Ise. Detection/Ale n_ Devices Space/Area Heating KW' 'un Na.of Dryers Heating Appliances ,Local i•4 Connection der `o.o "ater KW ecu ys ems: Heaters KW o,o ,o.0 No.of Devices or r r uivalent Si:ns Ballasts .eta Wiring: No.Hydromassage Bathtubs No.of Devices or E.ulvalent _ No,of Motors e econra:un canons `' : r n OTHER; Totat HPgg � - i , No.of Devices or . . Ive eat Estimated Nalu o�El trice!Work: Attach odditianal detail r wired or as required by the Inspector of Wires. Work Start: 2 (When required by municipal policy.) Work tot Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSUCOVERAGE: Unless waived by the owner,no permit for the performance the line provides proof of liability insurance including"completed operadoa"coverage of its subcat work mayuiv issue unless undersigned certifies that such coverage is in force,and has exhibited proof of same to the CHECK ONE: INSURANCE 0 0, S g or substantial equivalent. The I certify,under t'----+--- _..'_�,-r BONDX Omit) WO permitrlssuing office. WAYNE SCHMIDT Inform on on the `- FIRM NAME: "y,that the 1 ca n!s true and c mplete, ELECTRICIAN �� Licensee: - 222 WILLIMANTICLLS, DRIVE f.IC.NO. � (I applicable,exiedAkSTON8 MILLS MA 02648..... Signatu Address; (508)425-�747 one.) --------_....,_._.,, LIC.NO.: J '"Per M.O.L.c, 147,s.57-61,security Bus,Tel.No.: rn�'r'" O WNER S INSURANCE WAIVER: work requires Department of public Sato "Sn Alt.Tel.No.: _..:1�(atIMI 2/7 required by law.IN By%jIVER: I am a Safety License: Lin.No. Owner/Agent my signature below,I hereby aware Licensee requirement not have the k ono liability insurance coverage normally ,t! Signature downer owner's a ant. ...Telephone No. """ PRRurr PPP.'