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Home My WebLink AboutBLDE-23-005646 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-005646 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:4/10/2023 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) 21 ESSEX WAY Owner or Tenant KANTER DEBORAH Telephone No. Owner's Address ELKINS JAIME,21 ESSEX WAY, YARMOUTH PORT, MA 02675 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 boiler. 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 ❑ 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 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 q(13( Ftp.4.7. Commonwealth l Official Use O I ommoncuea o assat efts r�y e ft_ � f/ cc�� cc77 C� Permit No. L-Z3 - 5�:1-1 C� • -A el_ a T eparfinenf o/.}ire Jereices `� =j�=?� Occupancy and Fee Checked . s: .,7'7F BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C ee ),5t7 C12 (PLEASE PRINT IN INK OR P ALL INFORMA .ION) Date: ' ' City or Town of: ��0 V� To the Inspector of Wires: . By this application the undersign gives notice of his or her intention to perform the electrical work d cribed below. Location(Street&Number •�ss-�� l ^may JTI(-1 Owner or Tenant DJ)c � � �(,1 r Telephone No./30,7,_., I if( 0 . Owner's Address Is this permit in conjunction with a building permit? Yes El NoX (Check Appropriate Box) Purpose of Building D k AJ-Q \,\ \V\ Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead n Undgrd n No.of Meters Number of Feeders and Ampacity . L cati in and Nature of Proposed Electrical Work: (Ai I rc, 1`ep Lc& vv-e✓d )9-c Completion of the following table may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tf Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grad. Battery Units . No.of Receptacle Outlets No,o Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 'No.of Detection and /� Initiating Devices No.of Ranges No.o Air-cond Tons To No. of Alerting Devices • No.of Waste Disposers Heat Pump Number_ Tons ,_. KW_ No.of Self-Contained Totals: _ '"' Detection/Alerting Devices No.of Dishv,ashers Space/Area Heating KW• Local❑ Municipal ❑ Other - _ Connection Secure Systems:*_ No.of Dryers Heating Appliances KW No.of Devices or Equivalent No.of Water • No.of No.of q Heaters KW Data Wiring: _ Signs Ballasts No.of Devices or Equivalent • No.Hydromassage Bathtubs No.of Motors Total HP I'elecominunications 'W ii iiig: - -- f No.of Devices or Equivalent OTHER: • Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value_ f Elec 'cal Work (When required by municipal policy:) Work to Start: • ` Inspections to be requested in accordance with MEC Rule 10,and upon completion, INSURANCE C E GET 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,:xhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the veins and e na ies ofperiurv,that the inform Lion ott this pl. ation s true and complete FIRM NAME:_ WAYNE SCHMIDT I � 3/'C�� ELECTRICIAN �J LIC.NO.: j� U Licensee: 222 WILLIMANTIC DRIVE _ Signature (If applicable,ente.MARSTONS MILLS, MA 02648 , CAC.NO.: • Address: (508)428-7747 Bus.Tel.No.: coj�S 7 79J7/ *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 Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑owner Downer's agent. Owner/Agent Signature Telephone No. ` I PERMIT FEE: $ SO 1