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Home My WebLink AboutBLDE-23-003010 Commonwealth of Official Use Only fE Massachusetts Permit No. BLDE 23 003010 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:12/1/2022 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) 24 WARREN RD UNIT 30A Owner or Tenant CONWAY LEO J Telephone No. Owner's Address CONWAY MARY I, 24 WARREN RD UNIT 30A,YARMOUTH PORT, MA 02675-2533 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: Install generator 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 1 KVA 14 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. 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 ❑ 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 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 ofperjury,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 0,11,rV c/(1l 2 . Comrnonweafpt�i o///Iaaeachadattl Official Uea Only�y rat �,t �vie rn . Je artmant o�c7 Services Permit No, t P 91ra 1 'I` BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev,1/07] (leave blank) ----_._ _ APPLICATION.FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the assachusetts Electrical C,odei C),527 C1q 12.00 (PLEASE PRINT IN INK U L Date:_ I . 12 City or Town of: By this application the undersi To the Inspector of Wires: S ve�notice of his or herAtention to perform the electrical work described below. Location(Street Br Number) �.t'l r i`C IA Owner'or Tenant { C rg— Owner's Address A_ Telephone No, — c_^�/ _ • Is this permit in con]un lion with a b biding permit? yes [] No Purpose o;Building Check Appropriate Box) Utility Authorization No, Existing Service Amps • / olts Overhead Q, Undgrd❑ No,of Meters New Service Amps / yolts Overhead Nuinber of Feeders and Ampacity ❑ Undgrd❑ No.of Meters Locatf and N ire of Pro sed Electrical Work; t c,,N• h-�Y "> C' , ti `�- i • ti� • Corn•letton o the ollowin;table ma be waived by the lee enter of Wires. No.of Recessed Luminaires No,of Ceil,-Susp.(Paddle)Fans °•° Iota No.of Lurninaire Outlets No. Transformers KVA of Hot Tubs Generators �, . • No.of Luminaires Swimming Pool Above ❑ n- 0 `c,o merger rg t_ 1� r rnd. rnd. Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No,of Switches No.of Gas Burners o.o etec ton and • No.of Ranges Initiatint Devices No,of Air Cond. eta •No.of Alerting Devices p Tons um amber ens `o e tunab le No,of Waste Disposers Totals iDetectl n/Alertin Devices No of Dishwashers • Space/Area Heating KW Local P Munn a No,of Dryers Connection ❑Other Y Heating Appliances ICW ecnrtty rys[atnc;s—""-- o.o ater No.of Devices or E hinter, xw o,of „ „ quivalent Si ns Ballasts uses Wiring: No.Hydromassage Bathtubs No,of Motors Total HP No.of Devices or E uivalent • Telecommun cations Mug; OTHER; No.of Devices or Eguival`_ Estimated Value of Electrical Work: Attach additional detail if desired or as required by the Inspector of Wires. Work to Start; ° le. o b (When required by municipal policy.) INSURANCE COL '—Inspectionste 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 insurancethe 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 BOND ❑ OTHER El (Speci FIRM NMWAYNE SCHMIDT _—iailhe information on this application is true and complete. ELECTRICIAN ,� Licensee: 222 WILLIMANTIC DRIVE LIC.NO,: TIC c� (Ifapp1icabh MARSTONS MILLS,MA 02648 Sgna(ure • Address; (508)428.7747 LIC.NO,' *Per M.G.L,e,147,s.57-61,securityq Bus.Tel.No,:'--'r y N'f OWNER'S INSURANCE WAIVER:I em aware stDatphe Licensee does not have the liability Alt Tel.No. d51/i required by law, By my signature below,I hereb waive this re uirement. I am the(check one.[] re er/Agent Y q ty insurance coverage n normally ajiy Signatureowner : owner's a eat. Telephone No._—_ PERMIT FEE:�}