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Home My WebLink AboutBLDE-23-000280 Commonwealth of Official Use Only or i 0 Permit No. BLDE-23-000280 1-., ) Massachusetts 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:7/19/2022 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) 56 PAYSON PATH 1 e( EXP�-- ((Si 9 Owner or Tenant Helen Colford Telephone No. Owner's Address 56 PAYSON PATH,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: Replacement furnace&add on NC. 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- ElNo.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 1 No.of Detection and Initiatine 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 ❑ 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 (t4- 3ti -e-e�ew c� __�. i�� . Comozontusaith_ .t Official Use Only Apartment cc'77 p /� _ aParfinen#of J`ira.7crrricsa Permit No. ..� lU BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ev. 1/07] • eave blank -- APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL W All work to be performed in accordance with the Massachusetts Electrical Code C),527 21 ORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I City or Town of: YARMOUTH . By this application the dersi To the Inspector of Wires: geed_Ives notice Is or her intention perf... the eIectri • w•rk described below. • Location(Street&N mbe ) • .. ..A') (j , Owner*or Tenant � ' •� A 6 g -' lirek Telephone No. . . .� Owner's Address ', ;�� L Is this permit in conjunction with a btuilding permit? Yes ❑ No PurposeofBuilding ••. (Check Appropriate Box) ity—Authorization No. Existing Service Amps /__Volts Overhead New Service Amps Undgrd❑ No.of Meters Amps / Volts Overhead❑ Undgrd Number of Feeders and Ampacity No.of Meters a 4. Lo, t.on and Nature of Proposed Electrical Wor lel ��1{� Completion o the m llowin_ table . �0 No.of Recessed Luminaires be wa• ived h the Irrs.ector o Wires, No.of Cell-Susp.(Paddle)Fans o.of Total getNo,of Luminaire OutletsTransformers KVA No.of Hot Tubs Generators KVA • • No.of Luminaires Swimming Pool grn�e 0 In- ❑ o.o mergency ng arnd• Batte Units No.of Receptacle Outlets No.of Oil BurnersArlii FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners ( `o.of Detection and to No.of Ranges - Initiatin_ Devices No.of Air Cond. ota Tons . No.of Alerting Devices No.of Waste Disposers eat Pump umber Tons Totals: _ _• •----•---- o.of elf-Contain. n. No.of Dishwashers Detection/Alertin• Devices Space/Area Heating KW' Local❑ unicipal No.of Dryers Connection ❑ Other ry' Heating Appliances KW Security Systems:* - No,of rater No.o No.of Devices or El uivalent Heaters KWo.of Data Wiring: — Si ns Ballasts No.of Devices or E uivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E uivalent C 1 ork Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of lee (When required by municipal policy.) Work to Start: ' Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C GE: 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 X BOND ❑ OTHER Q. ( ��, I certify,under e----:--- --- -----'-- -`- n (Specify) this 1 K i "a' l FIRM NAME: INAYNE SCHMIDT y,that the information on icati n is[rue and complete. n� ELECTRICIA Licensee: 222 WILLIMANTIC DRIVE LIC.NO.: (If Licensee:--MARSTONS MILLS, MA 02648—_ Signatu le,ente (508)428-7747 'ne.) LW.NO.: Address: Bus.Tel.No.: j Per M.G.L. c. 147,s.57-61,security work requires Dc Alt.Tel.No.: �'�� OWNER'S INSURANCE WAIVER: I am aware that Department a does not Safety the liability insurance coverage normally No. S required by law. By my signature below, I hereby waive this requirement. I am the(check one ❑ 7 Owner/Agent owner y ' Signature CI a:ent. t?l Telephone No. — PERMIT FEE: $ ��