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Home My WebLink AboutBLDE-23-000660 _. --- Commonwealth of Official Use Only EL% . Massachusetts Permit No. BLDE-23-000660 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:8/9/2022 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) 308 ROUTE 6A Owner or Tenant KAREN STEVER Telephone No. Owner's Address 308 ROUTE 6A, YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes ❑ 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: Two split A/C's 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 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 2 Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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 pedury,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 (DILA 5( 1d1z3 eg,• ix , 1 I n =*_ CommonweaGtsli of//Iaddachudetttd • Official 1 gz Use Only �I c^� �� t 1,_ ',' `ment ol.Yira Serviced Permit No, l�- `' BOARD OF FIRE PREVENTION REGULATIONS ',: �+ Occupancy and Pee Checked ------_____ APPLICATION. FOR PERMIT TOP PERFORM I/o7� (leave blank) All work to be performed in accordance with the assach settss Electrical c C) 5 ELECTRICAL WORK �{ (PLEASE PRINT IN INK 0 ' L • , / IIII I C) 527 CMR 12.00 City or Town of I ,, Date: �� By this application or the undersign t % otice • To the Inspector of Wires; Location(Street& u ber) , R his or her ntention to perform the electrical work described below, Owner'or Tenant ` • " ' IA .--- Owner's Address ' � Telephone No. mil o` Is this permit in conjunction with a building permit? Yes 0 No (Check Appropriate Box) Purpose of Building „ 11 Utility Authorization No. . �etl!:g Service _1 Amps • / ;__....._.. .._.___ F ______._____Volts Overhead 0 Undgrd 0No.of Meters New---Service ..._.._ Amps Number of Feeders and AmpaciVolts Overhead 0Undgrd C No.of Meters _� AI Location and Nature of Proposed Electrical Work: wt ,ai1�R jam► -e-e No.of Recessed Luminaires Com,letion o t'e ollowin.. table ma be waived b the Ins ector of Wires, No.of Ceil.-Susp.(Paddle)Fans • o.o rota No.of Luminaire Outlets Transformers K No,of Hot Tubs Generators KVA • A No,of Luminaires Swimming Pool : bove ❑ In- `o mergence ig 1 tug No.• of Receptacle Outletsrnd, _Ind. Batt tea r Units No.of Oil Burners P'YRE ALARMS No,of Zones No.of'Switches No.of Gas Burners o. o t etectton and No.of Ranges otal Initiatin_ Devices No.,of Air Cond. Tons sr INo, of Alerting Devices No.of Waste Disposers• eat ump umber ons Totals: o, of a t= antained No,of Dishwashers (Detection/Alertitt_ Devices Space/Area Heating KW' ,Local❑ Munic:pa No.of Dryers HeatingAppliances Connection 0 Other o.o Dryers pP KVy, ecurity,ystem '.� Heaters ater KW �o.of O.o No.of Devices or E trivalent Sins Ballasts Data Wiring: Nc,ilj ui`GirlfiSSitge Bathtub Nm of Devi,,,a E iii valeill No,of Motors Total HPNo,of De Telecommunications ications iring OTHER: vices or E i trivalent Estimated Value c Work; Attach additional detail fdesired, or as required by the Inspector of Wires. • (When required municipal policy.) Work to Start; , Inspections to be requested in accordanceywith MEC Rule 10, INSURANCE V E: Unless waived by the owner,no permit for the performance of electrical work maytiss the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent, undersigned certifies that such coverage is in force,and has exhibited proof of same to thepermit issuingmay issue unless CHECK ONE: INSURANCEq alent, The I certl, ur ._ .—..... .. BOND OTHER office, �_ _ 0 (Specify;) FIRM NAI WAYNE SCHMIDT 'gat the information on this application is true and complete. ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE �� MARSTONS MILLS MA 02648 Signature � � LTC.NO.: +��`�� (Ifapplicabl (508)428 7747 Awn ' Vet NO.: • Address: • Bus.Tel.No.:- *Per M.G.L.MGL c, 147,s,57-ti I,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not haveAlt.Tel.No.:��, �7� required gy law, By my signature below,I hereby waive this requirement. I am the(checkLic,No, Owner/Agent h liability insurance owner coverage normally Signature one).❑ 0 owner's a ent, Telephone No. PERMIT FEE;$