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Home My WebLink AboutBLDE-23-004631 ;.,,,1-` ��- klx Commonwealth of Official Use Only ,, ��` Massachusetts Permit No. BLDE-23-004631 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:2/22/2023 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. Q Location(Street&Number) 8 CAPT WRIGHT RD 78 0 t — ! 0 / 7o Owner or Tenant SIMS ANDREW C Telephone No. Owner's Address SIMS RUTH MARIE, 13 BALSAM DR, CHELMSFORD, MA 01824 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: NC system(In attic) 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 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 Tonal 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 Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 Cil, • • Commonwealth al/rladaehadettJ • Official Use O'�nly t ccyy n�r �--C-S—`T :j( I I o Zepartmant o/.Y cc77 lre Jeralcea Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Chocked [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the assachusetts Electrical Cod C),527 0 (PLEASE PRINT IN INK L Date: l 1 _- City or Town of: To the Inspector of Wires: . By this application the undersign vas notice o his or he;mention to p form t o ctr cal work described below. Location(Street&Numbe Owner'or Tenant 1L S� 11{ Owner's Address Telephone No. �( L • • Is this permit in conjunction with a b rilding permit? Yes ❑ No Purpose of Building r 'y,'C/ 1 !\ �r El (Check Appropriate Box) Utility Authorization No,_ Existing Service Amps • / _'Volts Overhead New Service ❑ Undgrd El No.of Meters Amps /__,y0its Overhead❑ Undgrd Number of Feeders and Ampacity ❑ No.of Meters Location and Nature of Proposed Electrical Work: • Com.letlon o the ollowte table ma be valved by the his enter of Wires, No.of Recessed Luminaires No,of Ceil,-Susp.(Paddle)Fans • °•° 'fora TNo.of Lurninaire Outlets Transformers KVA No,of Hot Tubs Generators KVA No.of Luminaires Swimming Pool •hove ❑ n- 'a.o mergency sg 1 mg :rnd. 1rnd', ❑ Batter Units N No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No,of Switches No.of Gas Burners o.0 I etechon and No.of Ranges Initiatin_Devices Na. • • of Dishwashers Totals: ns �NO.of Alerting Devices Noat ofo. um Cond.Air o a No,of Waste Dis osers SpacMArs: ,NumKW' P p ,Number `' ` ontainer • ea Detection/Alertin:Devices unit al No.of Dryers Heating ;Local 0 Comtec ion ❑Other y Heating Appliances KW ecnrsty ystems: ""y"_ o,o ater KW `a,of .o °, No,of Devices or E.uivolent Heaters SinsBz:iasts Data Wiring. No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or E uivolent • Telecommunications firing; !` • OTHER; No.of Devices or E trivalent'�(� Egtimated Valuy�o Elect c 1 Work; Attach additional detail if deslred,or as required by the Inspector of Wires. Wo to Start; ---__ (when required by municipal policy.) SkRANCE CO Inspections tobe requested in accordance with MEC Rule 10,and upon completion, RAGE: 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 co erage is in force,and has exhibited proof of same to the permit issuing office, CHECK ONE: INSURANC BOND 0 OTHER� I cart ,at 0 (Specify:) .///`��JJJ) FIRM NA! wAYNE SCHMIDT a!the information on this application is time and complete. ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE LIC.NO.; y � �� (lfappllcab% MARSTONS MILLS,MA 02648 Signature ° �, • Address: (508)428.7747 LIC.NO,; ;Per M,G,L,c,147,s.57-61,security work requires Department of public Safe Bus'Tel,No,: •' ' , OWNER'S INSURANCE WAIVER: I am aware that theLicensee does not have the liability insurance ��/! Owner/Agent wner/ g law. By my signature below,I hereby waive this requirement. I am the(check one Lic.No. Ownred by la q coverage normally Signature owner 0 owner's a ant, Telephone No.___ PERMIT FLU;$ •