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Home My WebLink AboutBLDE-22-007448 ok Commonwealth of Official Use Only \'lid Massachusetts Permit No. BLDE-22-007448 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:6/28/2022 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) 422 HIGHBANK RD Owner or Tenant Jeff Marr Telephone No. Owner's Address 422 HIGHBANK RD,SOUTH YARMOUTH,MA 02664 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: Replace two NC condensers. 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. grn d. 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 I nitiatine Devices No.of Ranges No.of Air Cond. 2 Too5 I No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW_No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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 Sims No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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:$50.00 104),C5 A 611)423 d fir,g5L , Qj3Sf Commonwealth, o/711a.machwetto • Official Use Only l �iiJJ�r / Permit .�Z� 7 _ p 2epartme►t o/. Pe ira serulce� g C c BOARD OF FIRE PREVENTIONdi-gi Occupancy and Fee Checked ,, - .+ REGULATIONS Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM All work to be performed in accordance with the assachusetts Electrical ELECTRICAL WORK c ical Co ) C 00 (PLEASE PRINT IN IN, 0 rr2) t: L it i / Date: , City or Town of: To the Inspector of By this application the undersig - 'v notic of his or her ntention to perform the electrical work fires: C, I / . Location (Street & 'Umber) � � ,14 - 'work described below. ai Owner'or Tenant Telephone No. C`i ` ,53 Owner's Address ' Is this permit in conjun n with a,-building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building UtiYi A thorization No. . Existing Service Amps / Volts Overhead ❑, Undgrd ❑ No. of Meters e r� Ei ------ New S Amps / Volts Overhead Undgrd Ej No. of Meters • Number of Feeders and Ampacity • Location and Nature of Proposed Electrical Work: ' ,____CZ .Ser.L Com lesion o the ollowin table ma be waived h the Ins ector of Wires. No, of Recessed Luminaires No, of CeII,-Susp. (Paddle) Fans • o. o Tota Transformers KVA . No. of Luminaire Outlets No. of Hot Tubs Generators KVA • No. of Luminaires Swimming Pool Above ❑ In- 0 ' No. of Emergency Lighting grnd. grnd. B� attcry Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. ofSwitches No. of Gas Burners No. of Detection and • Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump umber ons o. o e - ontained Totals: Detection/Alerting Devices No, of Dishwashers Space/Area Heating KW' Local Municipal ❑ Other ' Connection No. of Dryers Heating Appliances KW Security stems;* ®" o No. of Water No, No. of Devices or Equivalent I eaters KW No. of Data Wiring: Signs Ballasts No. of Devices or Equivalent • No. Ilydromassage Bathtubs No, of Motors y w Total HP —r `t�'el oem non u ca c7Virtn I 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: ! inspections 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 the licensee provides proof of liability insurance including "completed operation" coverage or its substantial may issue unless undersigned certifies that such coverage is in force, and has exhibitedproof of same to ntial equivalent, The CHECK ONE: INSURANCE BONDthe permit issuing office, I c :..1 - 0 OTHER 0 (Speci WAYN E SCH M 1 DT ........ .. at the information on this application is true and FIRM NAIcomplete, ELECTRICIAN F LIC. NO.: ��,., �� ' Licensee; 222 WILLIMANTIC DRIVE 1 L a see: , MARSTONS MILLS, MA 02648 SignatureWC' • • ,l Pp l (508) 428-7747 LIC. NO,: Address: Bus, Tel. No.: tea, • *Per M.G.L, c, 147, s. 57-6 I, security work requires Department of Alt. Tel. No.: .'r,,AlJ' 21.7iOWNER'S INSURANCE VV'AIVEIZ: p Public Safety "S" License: Lic, No I am aware that the Licensee does not have the liability insurance coverage required by law. By my.signature below, I hereby waive this requirement, I am the (checkg normally Owner/Agent one .[] owner 0 owner's a ent, Signature Telephone No. PERMIT FEE, $ 1