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Home My WebLink AboutBLDE-22-006958 Commonwealth of Official Use Only ` Massachusetts Permit No. BLDE-22-006958 i 4\: , 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:6/2/2022 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) 10 SURRY LN Owner or Tenant CABRAL ADALINO Telephone No. Owner's Address CABRAL MARY C, 10 SURRY LN,WEST YARMOUTH, MA 02673 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 NC system(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 O Initiating Devices No.of Ranges No.of Air Cond. 1 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 0 Other: Connection No.of Dryers Heating Appliances KNN 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: (Whgn 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 belpw,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 913d' • ft Commonweakk of/ria9eachaeette • Official Use Only ( ri a Zepartmeni ol.yire serelces Permit No, -( r -off BOARD OF FIRE PREVENTION REGULATIONS ed Occupancy and Fee Checked_ [Rev.1/07 ve blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the assachusetls Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK 0 L City or Town of: Date: By this application the undersign Ives no ice of his or her ntention to perform the electrical k descrTo the ibed below. Location(Street& umber) ' I r L Owner'or Tenant U� L Owner's Addness —_`d Telephone No. —(; "1 • Is this permit in conjunction with a building permit? Ves No Purpose of Building ❑ (Check Appropriate Box) Utility Authorization No. Existing Service Amps •/ Volts Overhead Now Service ❑. Undgrd El No.of Meters Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: V r • V Completion of the following table may be waived by the Inspector of Wires, No.of Recessed Luminaires No,ofCeil,-Susp,(Paddle)Fans Noe of Total Na.of Lurninalre Outlets Transformers KVA No,of Hot Tubs Generators KVA No.of Luminaires Swhnndng Pool Above ❑ n- o.o mergency tg t mg • rnd. :rnd', Batter Units No.of Receptacle Outlets No,of Oil Burners FIRE ALARMS No.of Zones No,ofSwitches No,of Gas Burners ,.o,0 1 etectton an No,of Ranges Total Initiating Devices • No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump suBber ens '+r `o,o e . ontahted Space/Area ,... Totals: Detection/Alertitt_Devices No.of Dishwashers Heating KW Local 0 un ce pa No,of Dryers Connection ❑Other Y Heating Appliances KW ecurtty stems:* No.of Water No,of Devices or K.uivalent Heaters KW No,of No,of Data'Wiring,. Signs I,wSiast> No.of Devices m•E uivalent • No.Hydrotnaseage Bathtubs No,of Motors Total HP "elecoomnnications Warmg: OTHER; No,of Devices or E uivalent Estimated Value of E ctrical Work; Attach additional detail If desired,or as required by the Inspector'of Wires. Work to Start: (When required a municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COV' 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 coverage is in force,and has exhibited proof of same to the permit issuing office, CHECK ONE: INSURANCE BOND ❑ OTHER❑ (Specify:)I certify,to-......._.,_..._._.... FIRM NAI WAYNE SCHMIDT atlhe information on this application is true and complete. a 222 WILLIMANT C DRIVE JAC.NO.: , _i_.2� �t Licensee: MARSTONS MILLS,MA 02648 Signature f (Ifapplicabl (508)428.7747 LTC.NO.: • Address: Bus.Tel.No.; . ''Per M.G,L,c,147,s.57-61,security work requires Department of Public Safety"S"License: Alt Lie.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 0 owner's a ent. Owner/Agent Signature Telephone No. PEI211477'FEE:$ ,]