HomeMy WebLinkAboutBLDE-23-04502 or
Commonwealth of Official Use Only
1'�� Massachusetts Permit No. BLDE-23-004502
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:2/14/2023
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) 85 CURVE HILL RD
Owner or Tenant MAFFEI LORRAINE R TRS Telephone No.
Owner's Address MAFFEI THOMAS F TRS, 11 MARMION RD, MELROSE, MA 02176
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: Exterior hot tub and grounding. (Expired permit E22-2301)
Completion of the following table may be waived by the Inspector of Wire
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 g bovend. ❑ grnd. ❑ No.of Emergency Lighting
r 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. Total No.of Alerting Devices
To
No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained
Totals: Detection/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other:
Connection
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:
Siens _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 Win
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 operjury,that the information on this applications true and complete.
FIRM NAME: WAYNE B SCHMIDT
Licensee: Wayne B Schmidt Signature
LIC.el NO.: 33699
(If applicable,enter"exempt"in the license number line.)
Address:222 WILLIMANTIC DR, MARSTONS MLS MA 026481929 A Tel ::
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Allt.t.Tel.Noo..:
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. --
I PERMIT FEE:$50.00
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BOARD OF FIRE PREVENTION REGULATIONS May 1/07 and Pee Checked
APPLICATION 'P'0�,,'pRtev. Uo7" --....._
oavo blank
All work to be MIT TO PEI4FORM ELECTRICAL WORK
performed In accordance with the Massachusetts Electrical Cody mean
. (PLEASE PRtNTIN INK OR TYPE ALL INFORM T N) Date:
S City or Tom of: (�'�,� \ 3
y this application the},nder�igoed notio of h s or her intention t perform ii. TO St Inspector of Wires:
Location(Street&Number) work described below.
Owner'or Tenant
Owner's Address Telephone No. a'
I
Is this permit in conJunct[on with a building permit? y
Is Purpose of in cog �� yes 0 No
/ � (Check Appropriate Box)
Existing Service Utility Authorization No.
Amps —...... Volts Overhead��••••��
Ne Service Amps / �..1. Undgrd CI No.of Meters ��
Numb;:' ;
ts Overhead i :E
9' ❑ No,at Meterse of Proposed Eleatr[caI'Vt+orkt
T .
•
No,of Recessed Luminaires � Coat,letlan o the allowin. tab a at- be waived b the bts,eater o Wires,
No.of Ceil.-Susp,(Paddle)Fans -,o o
No•of Luminaire Outlets Transf• .ers ICVA
a g ng
No.of Hot Tubs
Generators KVA
No.of Luminairesnalres
S�ntmiug Pool :rnd e ❑ no , '• ' ',the •(sic
No.of Receptacle Outlets d• $$its Units
• No,of Oil Burners
No.of Switches PIRX Na,of Zones
No.of Gas Burners 0•pp e eC Am an.
No.of Ranges Inds a ee_ Devices
No.of Mr Cond. TnAMIMMIltis No.of Alerting Devices
•
No.of Waste --�
Disposers as ump
No,of Dishwashers °n °he
Detection/Ale n: Devices
Spacearea HeatingKW'
No.of Dryers Y.ocal[ un pa — -�.,
Heating Appliances C anactton ❑ tea'
o,o ��a or
CM y . ...
Heaters K `� o.a KW No.of Devices nr E uivois,t
o'o. Data VSlirtn .
Sins Ballasts $•No.Hydromassage Bathtu• � No,of Devices or E•uivalent
No.of Motors Totalit'IP a Nommon cat ono v r n
OTHER: No.of Devices or E.ulvilen _
Estimated Value o Elf; Attach addillaltal detail
tr10 W• i••wired eras required by .peator of Aquas,
Work to Start: y, (When required by municipal policy,)
Work
COVERAGE: peedons to be requested in accordance with MEC Rule l0y and upon completion.
RAGE• n ess waived by the owner,no permit for the performance of electrical work may
itis
the licensee provides proof of liability insurance including"completed operation"covemgc certifies that such coverage is in force, or'its substantial equivalent,e less
CHECK ONE: INSURANCE and has exhibited proof of same to the permit Issuing office, The
C ONB: rN __•... .C., BOND ❑ OTHER%(Specify') c" C�
WAYNE SCHMIDT '�•' form an on tls 1 ` C
FIRM NAMLr.. ELECTRICIAN
' ',that the In lc y Is true anti a mplete;Ltcenseer 222 WILLIMANTIC DRIVE ------
Licensee: 1.1C•NO•: it
lUapplicable,eARSTONS MILLS, MA �32648..,..Stgnatu "�.____
Address: (508)42t3• 74y rue.)
_._..,.._...._ Tel. NO.:
j Per M,O,1r,e, 147,s.57-61,seautity work requires Department cf Pnb Public Safetya ," •Bus, No.•
I
OWNER'S INSURANCE WAIVER: Yarn aware that the Licensee aloe S License; Alt.Tel.No.�x����
OWNER'S
by law, Byrac,No.
my signature below,I herebywai�,s s nae have the liability insurance covers o normally�' '","
t Owner/Agent ,� this roqutremcnt, I and,!re(ahc sk ane owns
Slgnahtre (�owner
.�� ,.w..,....,......+...,_,. ....._. •'slant,...Ain r►�,,,.t...�..,,,,.,,, .."�'r..._agent,