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Home My WebLink AboutBLDE-23-003810 for \ Commonwealth of Official Use Only L'E Massachusetts Permit No. BLDE-23-003810 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:1/13/2023 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) 67 AFT RD Owner or Tenant STEVE MEYTHER Telephone No. Owner's Address 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 ❑ 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: Install two split systems. 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 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 ❑ 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 ❑ 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 IN/144 (23( LL �' .441 `/Ar) 0_,s:/4-m ix 4(9 41.0,(6, - . -- fkt2.0_. .. -7C,C.- '5 L Commonwealth of Maasachudaits Of tcial•Use Oniy •------- n-i eUa arEmanl�o� Permit No. C.—_� ` 1 ;l�l - P Sire services 11 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev, 1/073 (leave blank) APPLICATION.:FOR PERMIT TO PERFORM ELECTRIC All work to be performed in accordance with the assachusetts Electrical Coe ' 12,00' y V (PLEASE PRINT IN 1N.CC t7 ", °` • .527 CMR City or Town of: 'r Date: �. � 3 1 tip. .0 , ,� By this application the undersign-: �� To the Inspector of Wires: g ves notice of his o her ntention to perform the electrical work described below. • Z , Location(Street&Number) A- Owner'or Tenant S t rL- Owner's Address _ Telephone No, _61 c • • Is this permit in conjun tton with a b rilding permit? 'Yes 0No , Purpose of Building F (Check Appropriate Box) Existing Service ____Utility,...uthorizatioil No. ¢_ Amps • / ,' Volts` Overhead ��•--�� `'�' New L._i, Undgrd Service -_. Amps / ❑ No, of Meters �, Number of Feeders and Ampacity ��Yolts Overhead [� Undgrd [J No.of Meters Lee Ion and turc of Proposed Electrical Work: �� ,�I�I 1_ - _ _ �''' Cornletien o the ollowln table ma be waived by the Iris ecto r o j l�rires: No.of Recessed Luminaires No.of Ceit,-Susp.(Paddle)Fans Transformers o,o rota llo.of Lutninafre O `� utlets No,of Hot Tubs Generators KVA • Ito,of Luminaires Swimming Pool rbtt e ❑ r- . ❑ o.o mergency ig 1 mg �;� No,of Receptacle Outlets Batter Units 7 ' No,of Oil Burners FIRE ALARMS No.of Zones r_ No,of'Srv►tches No,of Gas Burners o, o etectron and -" J No.of Ranges Initiatin Devices No,of Air Cond. ota Tons No. of Alerting Devices 4 No,of Waste Disposers eat ump umber ons Totals: ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, o.o e = ontained No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW' Local[� uri c pa No,of Dryers Connection ❑ Other y Heating Appliances KW ecurtty ystems:'' " "� `- o.o ater o of No,of Devices or l+auile Heaters KW o,o' Da, .al,ingo Y vunt Signs BallastsNo.of Devices or E uivalent • u No.Ilydromassage Bathtubs No.of Motors Total HP Telecommunications lying: OTHER: No,of Devices or Equivalent Estimated Value f El c ical Work: Attach additional emu tf desired, or as required by the Inspector of Wires. �� Work to Start; � "� Ins; (When required by municipal policy.) INSURANCE COVERAGE: .Unless waived by the owner,no permit d in dfor the performance of ance with MEC Rule elects al work upon completion,may ss the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent, The undersigned certifies that such co erage is in force,and has exhibited proof of same to the permit issuing off issue unless CHECK ONE; INSURANCE BOND ❑ OTHER, 0 b ice, —1 I cart ,ut -_._..._ ..... _.... . ... (Specify:) zi FIRM NM WAYNE SCHMIDT ''ai'the information on this application is true and complete. ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE LIC.N®.:A ' �' �` MARSTONS MILLS, Signature(Ifapplicabl MA 02648 • (508)428.7747 LIC.NO,: Address; Bus.Tel.No,: -�+ *Per M.G.L.c, 147,s, 57-61,security work requires Department of Public Safety"S"License: Alt. e.No. /d OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilityinsurance required by law. By my signature below,I hereby waive this requirement. I am the(check one . Owner/Agent coverage normally Signature d owner 0 owner's aeent, Telephone No. p.LRMIT FE.6:$ `'S 0