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Home My WebLink AboutBLDE-23-005783 Commonwealth of Official Use Only L. :*41 Massachusetts Permit No. BLDE-23-005783 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/N INK OR TYPE ALL INFORMATION) Date:4/19/2023 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) 17 CHASE GARDEN LN Owner or Tenant CAROLYN NASH Telephone No. Owner's Address 17 CHASE GARDEN LANE, 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement of 2 HVAC 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 2 No.of Detection and Initiatine 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 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 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 %k. L )( ( ) ► AxWC � 4N&Ace -PL-e c KG ��`3 • .. ommonruaalth of 1//a�sacelts • Official Use Only •=�i ' 2aparincent al ire Jervice6 Permit No. ! � %.; [Rev. BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked 1/07) • (leave blank) APPLICATION FOR'PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical CodL (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ),527 City or Town of: YARMOote ./ . By this application the 1.:ndersigned Ives no 'ce of hUTH ten'on to perform the electrical nspectorwork iesc Location (Street& `umber) ��tv descnbed below. Owner or Tenant C ( NC' i Y N.i f Owner's Address Telephone Na Is this permit in conjunction with a bu'ding permit? Yes El Purpose of Building D W& `•\\ VQ3 CCheck Appropriate Box) `J Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd El No.of Meters New Service Amps / Volts Overhead Number of Feeders and Ampacit;Locm. ❑ Undgrd E] NO.of Meters non and Nazi re of Proposed Electrical work: (_,,,) ce_,. .,.. se L * -C._e_i'vt-e_AA Completion of the allowin- table in. be waived b the Inspector o Wires. ,No.of Recess- Luminaires »>tic. of Cell.-Sus .(Paddle) No,of p Fans Transformers KVA ,No.of Lu niaaire Outlets No.of Hot Tubs Generators KVA .No.of Luminaires Swimming Pool Q Dove In- `o,o mergency g nng rnd. ornd. Batte Units _ • No.of Receptacle Outlets `No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of GBurners w o.of t eteehon and No.of'Ranges -- ta Initiatin_ Devices No.of Air Cond. °Tons No.of Alerting Devices eat Pump - umber_.. Tons o,of elf- ontaine, Totals: Detection/Alerting Devi No.of Waste Disposers ces No.of Dishwashers Space/Area Heating KW' Municipal Local— Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of eater KW o,o o.of No.of Devices or Ei uivalent Heaters Data Wiring: Si•ns Ballasts No.of Devices or Es uivalent No. Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsN o V.'uiva' OTHER: No,of Devices or E uivalent Estimated Valu o E e Attach additional detail if desired or as required by the Inspector ojr Wires. al Work (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE E E: 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 (Specify:) ( �� Ccrvv ° I certify,under t'---"-- - -''-- ( a fY) WO icK ist l`a' 1 FIRM NAME: WAYNE SCHMIDT y,that the information on this icati n is true and complete ELECTRICIAN _?2�/Iry Licensee: 222 WILLIMANTIC DRIVE LTC.NO.: --C-1-`=�`� Licensee: e,¢-MARSTONS MILLS, MA 02648____. Signatu e (508)428-7747 'ne.) LI NO.: Address: Bus.Tel.No.: �'� j 'Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety S"License: Alt,Tel.No.. �'7/ ,� OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage Lic. No. — required by law. By my signature below,I hereby waive this requirement. I am the(check one t Owner/Agent g normally LA Signature _ ❑owner 0 owner' a ent Telephone No. PERMIT FEE: $ h