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Home My WebLink AboutBLDE-23-001841 Commonwealth of Official Use Only Permit No. BLDE-23-001841 - ,� 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:10/6/2022 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) 27 MELVILLE RD Owner or Tenant JACKIE DORCE Telephone No. Owner's Address 27 MELVILLE RD, 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: Replacement furnace (Crawl space) 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 Initiatine Devices No.of Ranges No.of Air Cond. 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 accordancewith 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 , Cc\ ( z3 a (z3 ■•'♦ .viose. CRG-4-1- _________ill' -Th �- C,ommoncvaa/h o/�/Ia.6aaclsu.da�.4 • Official Use Only .._____1, ...-- II; Xit=fi .Permit �`13 '( �' ( cc�� No. =.l�1=5 Apart-mad ol glra�arvicab -1 Occupancy and Fee Checked r-:,,`� F BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR'PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 7 AMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1(„� City or Town of: YAROUTH the J To M Inspector of Wires: By this application the iundersigned giv r e o f)lis or hcr(ntpn Je to,p tIT electrical work described below. Location(Street&Number)-('A ry`t- 1.)j . - - 1,.. • i Owner.or Tenant CA.,.. '1 ' elephone No. 1 C Owner's Address SA-inel J-- Is this permit in conjunction with a bui)ding permit? Yes _ No 114 (Check Appropriate Box) Purpose of Building D A] \\ f \3 Utility Authorization No. Existing Service Amps / Volts Overhead ❑. Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Lo, tion Nature of Proposed Electrical Work: (. j f (� 4 Le �e7. A T (`-5 and �C�'i N I � Tyr c c r._L..L � : �. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires Na,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 - ernd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burnerso.of Detection and Initiating Devices Tota No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump Number..•Tons__KW _. No.of Self-Contained Totals: _ - Detection/Alerting Devices MuniciNo.of Dishwashers Space/Area Heating KW' Local❑ Connecholn � Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.KW No. of No.of Data Wiring: Signs Ballasts No.of Devices or Eq,.:,ale-nt 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 lec *c l Work: (When required by municipal policy.) Work to Start: ) C �� Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO ERkGE: 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 X(Specify:) (Jo cKers Czwp Icerttfy, under t'----=--- ---"--- -- -r_ WAYNE SCHMIDT y'that the information on this icati n is true and complete LIC.NO.: l FIRM NAME: ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE Si Hato �a MARSTONS MILLS, MA 02648— g LIC.NO.: (If applicable, ente (508)428-7747 'ne.) Bus.Tel.No.:�Q` 17 • Address: Alt.Tel.No.: (J� ]] / J *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner El owner's agent 7 Owner/Agent ___ _ r 1_I Signature Telephone No. . I PERMIT FEE: $ _ C` � / _� `°� | . / . � , - � | ' _ ~__- -__- � . �� ~-----r-�� -�--� | | / � � / . - _ - ___ __- __-_-�_ ~� ,�'' __^_-_�_ '_-- -___-_-___ -_ __ � ` | � [ |