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Home My WebLink AboutBLDE-22-004482 Commonwealth of Official Use Only �`' Massachusetts Permit No. BLDE-22-004482 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:2/14/2022 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 glee I work described bel w. Location(Street&Number) 18 BLUEBERRY PATH VILLAGI S T 1 ( V 4 L-i t-_. Owner or Tenant Telephone No. Owner's Address VIC6 `4$ P�ER f 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: Replacement furnace. 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. 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 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 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.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 N Via 2:64(77.-- ---- cS 2(4-2 e€,€,-_ . Co,nmonwca[th o M / „-_-=�t ///assachuscffo _Official Use Only. • i =.=/1l= ° Apartment o�,}ire_5 Permit No.�� .G P arvicsd ` - Occupancy and Fee Checked >-:, ,�,F BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07) • -- (leave blank) APPLICATION FORPERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C e C 5 7 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: YAR MOUTH To the Inspector of Wires: By this application the pndersigned ives of hi or her intention to orm the electrical work described below. Location(Street& tuber) ! c- Owner'or Tenant , r 1-Qi{.'�I� V � `�. Telephone No. ' g3 Owner's Address /' 1 inn L Is this permit in conjunction with a u'di � ng permit? Yes ❑ No6 (Check Appropriate Box) Purpose of Building \ Y\__S Utility Authorization No. Existing Service_ _i Amps / Volts Overhead ❑. Undgrd❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity • Lo lion and Nature of Proposed Electrical Work: v Completion of the following table may be waived by the Inspector o 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. mid. Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No,of Switches No.of Gas Burners o•of Detection and Initiating Devices No.of Ranges N ► 1 o.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump 1 Number Tons No,of Self-Contained - Totals:I� -_.�-_`- -�KW"—`-- Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local❑ Municipal Connection No.of Dryers Heating Appliances KW "ecurity Systems:* No.of Water No.of Devices or Equivalent of No. No. of Heaters KW Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: IO'I i3ER: No.of Devices or Equivalent Attach additional detail if desires(or as required by the Inspector of Wires. Estimated Valu Ele . aZorlc (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO E GE: 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. El ONE: INSURANCE X BOND OTHER X(Specify:) (J Carty o cKers 1 I certify, under t'----°--- ----1----'-- - WAYNE SCHMIDT y,that the information on this icati n is true and complete FIRM NAME: ELECTRICIAN l LIC.NO.- q Licensee: 222 WILLIMANTIC DRIVE MARSTONS MILLS, MA 02648 Stgnatu / _� LIC.NO.: (If applicable, erne (508) 428-7747 'ne.) ] Address: Bus.Tel.No.: i1•-7fr Per M.G.L.C. 147,s.57-61,security work requires Department of Public SafetyAlt.Tel.No.: / '� P "S"License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below, I hereby waive this requirement. I am the(check one) El owner ❑owner's a ent. 7 Owner/Agent _ f Signature Telephone No. PERMIT FEE: $