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Home My WebLink AboutBLDE-22-006957 • ,��'� Commonwealth of Official Use only ;� � Massachusetts Permit No. BLDE-22-006957 . 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:6/2/2022 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) 277 HIGHBANK RD Owner or Tenant Nate Adleman Telephone No. Owner's Address JJJC«<//// Is this permit in conjunction with a building permit? Yes ❑ No ❑ (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 HVAC 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 Initiating Devices No.of Ranges No.of Air Cond. 1 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 0 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 ❑ (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 5 I j/ i43 10 .F.e.-- - 5?Y CI<G-- 12 _ommowca a o///Ia68achett.1 • Official Use Only : fit-= Permit No. e22-rP�57 _ 11�.= = aparfmant° iro�craiccs =' ' Occupancy and Fee Checked r-..� ;�,." BOARD OF FIRE PREVENTION REGULATIONS Rev. l/07] -- (leave blank) APPLICATION FOR'PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C C 7E2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:L 1 City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersi ed fives otice his rtention to o the electrical work described below. Location(Street&Number) A� sor Owner.or Tenant _NI �� e a `� Telephone No. � ; ; IS Owner's Address SPY.4VW r ` y` - Is this permit in conjunction with a builing permit? Yes d� � `` ❑ No (Check Appropriate Box) Purpose of Building D rW '\i\) Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd g 0 No.of Meters Number of Feeders and Ampacity e Lotion and Nature of Proposed Electrical Work: Le jAeAA, T 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 El 0 No.ot.Emergency Lighting - grnd. _grad. Batte Units No.of Receptacle Outlets No.of Oil Burners � ' FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners '� l 1; o.of Detection and yyy"' 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 No.of Dishwashers Space/Area Heating KW Local Municipal 0 Other ❑ Connection No.of Dryers Heating Appliancest Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of Heaters KW Ballasts Data Wiring: Signs No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: II No.of Devices or Equivalent OTHER: Attach additional detail if desirert or as required by the Inspector of Wires. Estimated Value e c 1 Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE 0 R4GE: 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 P.; BOND ElOTHER X(Specify:) (Jo(-Kerr C"' l I certi , under t'-------- -- WAYNE SCHMIDT y,that the information on this icati n is True and complete . 3600 FIRM NAME: ELECTRICIAN LIC.NO.:_y— t Licensee: 222 WILLIMANTIC DRIVE Ck. MARSTONS MILLS, MA 02648_ Signat3k/3 LIC.NO,: (If applicable,ente (508) 428-7747 'ne.) _______________ . Address: Bus.Tel.No.: -�/ j "Per M.G.L. c. 147,s.57-61,security work requires De artment of Public Safe Alt.Tel.No.: / p ty"S"License: Lic. No. vzt OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally 5 required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑owner ❑owner's ag t. 0.1 Owner/Agents lsd Signature Telephone No. .• - I PERMIT FEE: $