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Home My WebLink AboutBLDE-22-003026 � Commonwealth of Official Use Only - IE`' 1 Massachusetts Permit No. BLDE-22-003026 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:11/24/2021 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) 114 WHARF LN Owner or Tenant PERERA RONALD C Telephone No. Owner's Address 703 FAIRWAY VILLAGE, LEEDS, MA 01053 4‘` Is this permit in conjunction with a building permit? Yes 0 No 0 (Ch p r4t � Purpose of Building Utility Authorization No. V Existing Service Amps Volts Overhead 0 Undgrd 0 . f lee er New Service Amps Volts Overhead 0 Undgrd 0 No.�f _ �� Number of Feeders and Ampacity <3 v 1? Location and Nature of Proposed Electrical Work: Split A/C system V Completion of the following table may b� b e n ector 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 Initiatine Devices No.of Ranges No.of Air Cond. 1 Ton l 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 ❑ 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 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 F .., cfc.4.3.73 4x. --)L Commonwealth o/Maaachudettd Official Use Only"�i=�t cc�� cc77 Permit No. _'ek ..Department°I.ylra Serulcea t✓Z� - ` 0 —`f� ,.Lf , BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the assachusetts Electrical Code C),527 CMR 12.00 (PLEASE PRINT IN INK O L CIR i. • IDate: l I W12-I City or Town of: 0 i To the spector of Wires: . By this application the undersign Ives notice o his or )er ntention to perform henelectrical work described below. Location(Street& umber) j- Owner'or Tenant S i , e --e jwL • Owner's Address Telephone No. 6-_.y(•— c. j Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building ;-�t ` r ❑ (Check Appropriate Box) �'� �`-�__ `. `� J _ Utility•:4.uthoriLrtion No. Existing Service Amps • / Volts Overhead ❑. Undgrd ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd Number of Feeders and Ampacity g ❑ No.of Meters Location anti Nature of Proposed Electrical Work; Lt 1 i )i-C, . Ott k. \ L./\,-) S livi, i) (..... . ,_ )(c-\ -e- IN \ Completion of thefollowing 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 1No.of Zones No,of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons No. of Alerting Devices No.of Waste Disposers• Heat Pump 1 Number 1Tons ]KW No, of Self-Contained j Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Municipal ❑' Connection ❑ Local Other No,of Dryers Heating Appliances KW Security Systems:* No.of Water No.ofNo.of Devices or Equivalent Heaters KW No.of Data Wiring: _ Signs Ballasts No.of Devices or Equivalent • No.Hydromassage Bathtubs ___ No.of Motors r Total HP T3I•" """.• ..`'._. iel _, ,., ...fDe ices,or rqu v V No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Valu o • ec i r (When required by municipal policy.) Work to Start: spections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: nless 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 co erage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Itio BOND 0 OTHER 0 (Specify:) I certify, ut -....---- , WAYNE SCHMIDT ''at the information on this application is true and complete. FIRM NAI ELECTRICIAN f al 4 222 WILLIMANTIC DRIVE LIC.NO.: ir^ Licensee: MARSTONS MILLS, MA 02648 Signature �..�. v �' LTC.NO.:(lfapplicabi (508)428-7747 • • Address: Bus.Tel.No.:river-al *Per M.G.L. c, 147, s. 57-61,security work requires Department of Public Safety"S"License: Alt L cl.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)0 owner ❑owner's agent, Owner/Agent Signature Telephone No. I PERMIT FEE:$ 50 I