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Home My WebLink AboutBLDE-23-18943 6/16/23,6:08 AM about:blank m `'��l Commonwealth of Massachusetts 7111 ,° Town of Yarmouth ° t41tl '.0 d y' ELECTRICAL PERMIT `k, xs Job Address: 33 APPLEBY RD Unit: Owner Name: COULOPOULOS DIANE TR 28 GLENN ROAD REALTY TRUST Owner's Address: 28 GLENN RD Phone: Email: Purpose of Building Residential Utility Authorization No.: Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-18943 Existing Service Amps/Volts Overhead ❑ Underground ❑ No.of Meters: New Service Amps/Volts Overhead❑ Underground ❑ No. of Meters: Description of Proposed Electrical Installation: 3 Head split A/C system No.of Receptacle Outlets: No.of Switches: Generator KW Rating: Type: No. Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating: No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW: No. Heat Pumps: Total KW: Total Tons: Fire Alarm System 0 No.of Devices: Swimming Pool: In-Grnd.❑ Above-Grnd.❑ Hot Tub❑ No.of Self-Contained Detection/Alerting Devices: No.Oil Burners: No.Gas Burners: Video System ❑ No.of Devices: No.Air Conditioners: Total Tons: Telecom System ❑ No.of Outlets: No. Energy Storage Systems: KWH Storage Rating: Security System 0 No.of Devices: Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment: No.of Modules: Roof-Mount❑ Ground-Mount❑ Level 1 ❑ Level 2❑ Level 3❑ Rating: Estimated Value of Electrical Work: $ 1 Work to Start: June 16, 2023 FIRM NAME: License Number: Master/System and/or Journeyman Licensee: WAYNE B SCHMIDT License Number: 33699 Security System Business requires a Division of Occupational Licensure "S" LIC. License Number: Address: MARSTONS MLS, MA, 026481929 MARSTONS MLS MA 026481929 Fee Paid: $50.00 Email: wayneschmidtelectrician@yahoo.com Business Telephone: 508-428-7747 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!' � � INSURANCE: [ J Z''j tJ`/ `" Ci s� 7o A44 — b ots tic C Cc,LA_D t, ce4t,c. / 1/1 about:blank 1eO C 37)3 --..- • Commonwealth of Massachusetts Official Use Only,Permit No.: ,,,,, i_-3 — i --;'j 13 -z 41 Department of Fire Services Occupancy and Fee Checked: Ii y BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023j • Ly APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in aceordancewith the Massachusetts Electrical Code(MEC,);524 CM 1.�.0 City or Town of: YARMOUTH Date: �� ` r✓ To the Inspector of Wires:By this applicatio the un` rsigned givsinotices of his or her intention to perform the electrical work described below. ' Location(Street&Number): 33 V t t C 1J`i A* Unit No.: Owner or Tenant: V` C\ -e. U t 1 ) I i 6 Email: II 7 t} // Owner's Address: `- I � Phone No.: t -5`/ I I l V� Is this permit in conjunction with a building permit?(Check appropriate box)Yes 0 No'Yermit No.: Purpose of Building: 0 ki J ,\\\Vim', Utility Authorization No.: Existing Service: Amps / Volts Overhead 0 Underground❑ No.of Meters: . New Service: Amps / Volts Overhead 0 Underground N .of Meters: .,. DeSt,r"'titan of Proposed .lectricai Installation: (,k.j C'S -Z v,{,, M \CIA C I , _ ...: V'V"\ Completion of the following-able may be waived by the Inspector of Wires. No.of Receptable Outlets: No.of Switches: Generator KW Rating: Type:. No.Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating: No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No:Motors: Total HP; Total KW: No.Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of Devices: - Swimmirig Pool:In-Grnd.❑ Above-Grnd.0 Hot-Tub 0 No.of Self-Contained Detection/Alerting Devices: No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices: No.Air Conditioners: • Total Tons: _ Telecom System ElNo.of Outlets: No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of Devices: vcD Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply E ui e r I pP Y q Pin tilt:• _ No.of Modules: Roof-Mount 0 Ground-Mount 0 Level 1 0 Level 2❑ Level 3 0 Riding: r� oT --, V 15 2�Z3 `s E __.. Attach additional detail if desired,or as required by the Inspector of Wires. S U I L DING U E PA R l MEN T I Estimated Value of Elle t i Work: (When required by inuni Date Work to Start: 6 - ' - Inspections to be requested in accordance with MEC Rule 10,and upon completion. • FIRM NAME: A ow\'i citt �A �fCI 0 -1 ❑or C-1 ❑LIC.No.: Master/Systems Licensee:Q` u LIC.No.: Journeyman Licensee: V `fi 11!� ` C fir` �.1-C� LIC.No.: j_3 C 11i Security Addr SS ste sines requires a Division of 0 cupational Licensure"S"LIC. S-LIC.No.: UU' i t 11' L n I r I Iti-c Ii . 1 % i. l n�7 7 Emat � ,^ L ._ ®' . ' . p, ✓ U+' 1; Telephone No.: C a'- LI I certify,r der t e pain" nd penalties perjury,that the information on this application is true and complete. Licensee: Print Name: ty t' C VW Air Cell.No.:bC 'r <3/ 7/ INSURANCE COV AGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee . provides proof of liability including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force and has exhibited proof same to the permit issuing office. CHECK ONE: INSURANCE Li' BOND 0 OTHER 0 Specify: OWNER'S INSURANCE W,A R: I am aware that the Licensee does not have the liability insurance coverage normally required by law.By my sig ture ow,I hereby waive this requirement.I am the:(Chec ne) tier 0 Owner's agent❑ Owner/Agent: ..,_ Tel.No.: Signature: Email.: