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Home My WebLink AboutBLDE-23-001901 Alf Commonwealth of Official Use Only IE` Massachusetts Permit No. BLDE-23-001901 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:10/11/2022 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) 49 CANTERBURY RD Owner or Tenant BRAD McCLAY Telephone No. Owner's Address 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: Miscellaneous work per attached. 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. 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 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 'Pret,.-56 , C*1' k:k, '") '- • Commonwealth oQ l /�/addaciiu�ett� Official Use Only .'vas___ Permit No. C.,2-5-AC( 0 .mil_ department o� f^�ir J _ ,.Y�cre erulcea • '4:6 BOARD OF FIRE PREVENTION REGULATIONS Recc 2pancy and Pee Checked /07] (leave blank) APPLICATION. FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the assachusetts Electrical Co e (PLEASE PRINT IN IN. O• , ` NEC), z7 MR 12.00 � L �� Date: � �City or Town of: 'k t tXt r /‘ �: By this application the undersig !Ives notice of his or her tendon to perfor, n the electrical Inspector work described below. . Location(Street&Number) C Cl'\.V1 -e i, I 1" Owner'or Tenant 11j j L kc -Vk Owner's Address Y Telephone No. jt"j Is this permit in conjunction with a building permit? Yes F-J Purpose of Building 0 ��,.�� No n (Check Appropriate Box) Utility Authorization No. Existing Service. _ Amps Volts Overhead -____ �` • ❑, Undgrd 0 No.of Meters Now Service _ Amps /__.Volts Overhead Number of Feeders and Ampacity ❑ Undgrd 1-1 No.of Meters _ JDaJjU7PrOPOSed Electrical Work• :• A� 1i,16a111111 , 1011MEROMM_ .fir • U. . Completion of thefollowlng_table ma •e waived by the Inspector of Wires.l No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total No.of Lutninaire OutletsTransformers KVA No.of Hot Tubs Generators ICVA • No,of Luminaires Swimming Pool rbit a• ❑ Ind'. ❑ Baoef y Uni gency Lighting No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo,of Zones No.ofSwitches No.of Gas Burners No. of Detection and No.of Ranges "Total Initiating Devices No.• of Air Cond. Tons No. of Alerting Devices No,of Waste Disposers Ileat�ump Number Tons IC W f`No. of Self-Contained Totals: �,.,,.,,,,, Deteetion/Alerting Devices No,of Dishwashers Space/Area Heating KW' Local Municipal ❑' Canirection ❑ Other No,of Dryers Heating Appliances KWecurity stuns 4�...,' -__ ."-' No.of Water No.of No.of Devices or Equivalent Heaters KWNo.of Data Wiring: Signs Ballasts No.of Devices or Eouival?nF • Ne r's-•r»r_._.,3s- ieleconimun cations'Wiring: "'~°'� a lya.iiraias jNo, of Motors Total HP No,of Devices oi•Equivalent OTHER: L.r t�c Gt L\j • Estimated Value of Electrical / Attach addit onal detail If desirbd, or as required bythe Inspector Work: (When required by municipal policy.) p of wires. Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion, t �, �� 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 co erage is in force,and has exhibited proof of same to the permit issuing office, CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) Icertify, to .._ ......._..... .. _ WAYNE SCHMIDT 'sat the information on this applicationis true and corr:plete..FIRM NAI ELECTRICIAN LTC.NO,: ,., �� Licensee; 222 WILLIMANTIC DRIVE Licensee:(If - MARSTONS MILLS, MA 02648 Signature f,' J LTC.NO,; • Address: (508)428.7747 Bus.Tel,No,:' _ '^` *Per M.G.L,c, 147,s.57-61,security work requires Department of Public Safety"S"License: LiAtt. c.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 ant. Owner/Agent Signature Telephone N.o. PERM1ITFEE:$ L