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Home My WebLink AboutBLDE-23-000136 - i- Ve Commonwealth of Official Use Only i Massachusetts Permit No. BLDE-23-000136 � 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:7/11/2022 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) 126 THACHER SHORE RD Owner or Tenant PERERA PHILLIPS JR TR Owner's Address PERERA FREDERICA P, 40 EAST 94TH ST APT 30A, NEW YORK, NY 10128 Telephone No. Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Purpose of Building Appropriate Box) Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 New Service gNo.of Meters Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement A/C 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 I No.of Zones No.of Switches No.of Gas Burners No.of Detection and ' Initiatine Devices No.of Ranges No.of Air Cond. 1 Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection ❑ Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Ballasts Data Wiring: Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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(If applicable,enter"exempt"in the license number line.) Tel. NO.: 33699 Address:222 WILLIMANTIC DR, MARSTONS MLS MA 026481929 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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. N (PERMIT FEE: $50.00 5(t l23 /A- — ` -(r Cep &2, 1-.\\j 00.---. 3 Commonwealth �j� • ___ tit ►nonweaGth 01 211 a�eac�xusatt$ • Official Use Only m Permit N —JePartment o eraservlceoI BOARD OF FIRE PREVENTION REGULATIONS <.,;,»r Occupancy and Fee Checked APPLICATION. FOR PERMIT PERFORMTO [Rev' 1/o7J (leave blank �"`--- All work to be performed in accordance with the assa t CCa ELECTRICAL, 7 R 12.00 (PLEASE PRINT IN IN.. 'p L C. 7fMR 12.00 City or Town of; Date: To the Inspector of Wires: By this application the undersign iv no his or ntention to perform the electrical w k escribed below. • Location(Street&Number) i Owner'or Tenant erelz Owner's Address ' �'j Telephone No. • Is this permit in conjun lion with a building permit? Yes No •. (Check Appropriate Box) Purpose of Building ' , Existing Service Utility:Authorization No, Amps '' Volts Overhead New Service D. Undgrd 0 No.of Meters Amps /Volts Overhead I--� Number of Feeders and Ampacity 0 Undgrd ❑ No.of Meters __ Location and Nature of Proposed Electrical Work: 1 ,r , No.of Recessed Luminaires Com'letlon o the ollowin; table ma be waived by the Inspector of Wires, No.of Ceil.-Susp.(Paddle)Fans o.o Tota Transformers No.of Luminaire Outlets KV No.of Hot Tubs KVA No.of Luminaires Generators KVA Slvimimiilg Pool ' hove n- `o,o Units mergency ig 1 lug No.of Receptacle Outlets :rnd. ❑ l rnd'. ❑ Batter Units _ No.of Oil Burners FYRE ALARMS No.of Zones No,of'Switches No.of Gas Burners -to.o "t eteetzon and No.of Ranges ota Initiatin_ Devices No.of Air Cond. No.of Waste DisposersTons No.of Alerting Devices eatump umber ons Wily 'so.o e ontaine Totals: .,.,•,,,,,,,, No,of Dishwashers • Space/Area Heating KW' Detection/Alertin! Devices No,of Dryers Local❑ Municipa Heating Appliances Connection ❑ Other No.o ater KW ecurtty ystems:* Yeaters KW o.of - No.of Devices or E uivalent _Slams_ __M Ballasts Data Wiring; No.Hydromassage Bathtubs ---------------Telecommunications of Devices or E uivalent • No.of Motors Total HP Telecommunications firing; OTHER: No.of Devices or Equivalent Estimated Valu Ele r' afo:ki Attach additional detail tfdesired, or as required by the Inspector of Wires. Work to Start: (When required by municipal policy.) INSURANCE Inspections to be requested in accordance with IVIEC OVE GE: Unless waived by the owner,no permit for the performance of electrical e 10,and work completion. the licensee provides proof of liability insurance including"completed operation"coverage or undersigned certifies that such co erage is in force,and has exhibited proof of samemay issue unless g its substantial equivalent, The BOND OTHERta the permit issuing office, CHECK ONE: INSURANCE0 (Specify:) FIRM NA! WAYNE SCHMIDT ,gat the information on this application is true and complete, ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE fT ?' MARSTONS MILLS, MA 02648 Signature _ � LIC.NO.; ,,� , ' Address; ("008)428.7747 LIC.NO,; *Per M.G.L. c 147, s. 57-61,securityBus.Tel.No,: *co le oar 217 OWNER'S M. INSURANCE work requires Department of public Safe Alt'Tel No.: required bylaw, ByWAIVEp Safety"S"License: i R: Iam aware that the Licensee does not have the liability insurance re Owner/Agentd my•signature below,I hereby waive this requirement. I am the(check one). Signature 6 normally Telephone No. ❑owner 0 owner's a.ent. PERMIT FEE:$ �. .