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Home My WebLink AboutBLDE-23-001217 Commonwealth of Official Use Only ' L Massachusetts Permit No. BLDE-23-001217 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:9/6/2022 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) 844 WEST YARMOUTH RD Owner or Tenant SMITH ROBERT H Telephone No. Owner's Address SMITH JOAN A, 844 W YARMOUTH RD,YARMOUTH PORT, MA 02675-2354 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 HVAC 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 1 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 p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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 'F-ee„..:5-0 CSC" -G _ _ _ Commonwealth.olass� a(f� Official Use Only -,fit_- �.etti= - aP s iitNo . _ 3 l L __ arfin¢nf o/�ira arvica9 • t Occupancy and Fee Checked `Y-:•= ;t,.F BOARD OF FIRE PREVENTION REGULATIONS ev. 1/071 eave blank APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C (PLEASE PRINT IN INK OR TYPE ALL INFORM4TION) Date: 27t City or Town of: YARMOUTH T �'ir . By this application the wutdersign d iv s otic of his or her intention to orm the I e e(rircal work des described belo . Location(Street umber) 4. Owner or Tenant Telephone No. • Owner's Address Aii Is this permit in conjunction with a building permit? Yes D t - t tA j \ n3 ❑ tNoy (Check Appropriate Box) Purpose of Building ll�J \ Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd EI No.of Meters New Service Amps / Volts Overhead Undgrd ❑ No.of Meters Number of Feeders ni,o ii.. parity Lo ation and Nature of Proposed Electrical Work: e -e Compl on of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceit.-Susp.(Paddle)Fans No.of Total No.of Luminaire Outlets Transformers KVA Na.of Hot Tubs Generators KVA - • No.of Luminaires Above In_ No,of Emergency Lighting Swimming Pool - i:rnd. arttd. ❑ Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners c..INo.of Detection and -Initiating Devices No.of Ranges No.of Air Cond. °mil - Tons No,of Alerting Devices No.of Waste Disposers Heat Pump Num er Tons KW No,of Self-Contained - Totals:l".� "�'�`- �""� -- Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local❑ Municipal Connection No.of Dryers Heating Appliances , Security Systems:* No.of Water No.of No.of Devices or Equivalent • Heaters KWNo.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: `` No.of Devices or Equivalent • Ir1C 'r /� Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of lec *cal Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C ER4GE: 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 0 OTHER (Specify:) (Jos c-K€ s �`""' l I certify, under t` - ( Pe fY) FIRM NAME: WAYNE SCHMIDT y,that the information on this iced n is true and completes ELECTRICIAN l LIC.NO.: � � Licensee: 222 WILONS MILLS, DRIVE N L —MARSTONS MILLS, MA 02648� Stgnatu LIC.NO.: (If applicable, ente (508) 428-7747 'ne.) _______,__ Address: - Bus.Tel.No.: - l•�] J Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lic.Te 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 ❑owner 0 own• ' •ent. t Owner/Agent _ t,I Signature Telephone No. • PERMIT FEE: $