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Home My WebLink AboutBLDE-22-003666 • Commonwealth of Official Use Only titi. Massachusetts Permit No. BLDE-22-003666 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:12/30/2021 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) 48 WENDWARD WAY Owner or Tenant HYDER FREDRIC J Telephone No. Owner's Address HYDER CONSTANCE H, 11 OLD FARM RD, RANDOLPH, MA 02368-2555 Is this permit in conjunction with a building permit? Yes 0 No 0 (Ch eels Appopridte jaox) , Purpose of Building Utility Authorization N ` j Existing Service Amps Volts Overhead 0 Undgrd 0 J `�f o New Service Amps Volts Overhead 0 Undgrd 0 Ij o to ) Number of Feeders and Ampacity rr _ Location and Nature of Proposed Electrical Work: Wire furnace and AC condenser, install receptacle for water h r k� ,7 ' Completion of the following table ma aii1e ~~"'lector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Transformers if ti s. KVA al No.of Luminaire Outlets No.of Hot Tubs Generators f 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 Initiatine 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/Alertine 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 Eauivalent 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 , ci,(G__. --- .re,e.,____ ..,...g) Commonwealth of 7aesacisusattd Official Use Only � `_ cc�� c7 Permit No. , /1�= = 2eparfmcnt oiI.. ire�ervicss1-:71 C�ZZ- 3te(� --�_- ;e Occupancy and Fee Checked >.--. ,r. 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 Code 527 C 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: fi- ` 7 zi City or Town of: YARMOUTH To the Inspector of ires: By this application the undersigned ive no ce of his Rr her intend n to perform the electrical work described below. Location (Street&Number) L �tek IAJct Wet Lk fir. ( Owner or Tenant Telephone No. —"CV( 7 Owner's Address / L Is this permit in conjunction with a bui)ding permit? Yes ❑ No1%1 (Check Appropriate Box) Purpose of Building D V�1 \\n3 Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity • ,Lo on Naturere of Proposed Electrical Work: fur ., e -Fvr r I R1 , Completion of the followin&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 Qrnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.of Zones ---. Ci) No.of Switches No.of Gas Burners No.of Detection and J Initiating Devices 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 El Municipal 1-1 Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No. of No. of Data Wiring: - Signs Ballasts 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 o I .c r : (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE G U less 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 X BOND ❑ OTHER X(Specify:) WO cK s C" ' 1 I certib,, under t`----'--- ---' WAYNE SCHMIDT y,that the information on this icati n is true and complete FIRM NAME: ELECTRICIAN LIC.NO.:- �C1 Licensee: 222 WILLIMANTIC DRIVE MARSTONS MILLS, MA 02648 �� LIC.NO.: — SigHato (If applicable, ente (508)428-7747 'ne.) . Address: Bus.Tel.No.• Alt.Tel.No.: 1 � 7/ J *Per M.G.L. c. 147,s. 57-61,security work requires Department of Public Safety"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)❑owner ❑o 's genL 7 Owner/Agent — �� Signature Telephone No. ( PERMIT FEE: $