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Home My WebLink AboutBLDE-22-007340 Commonwealth of Official Use Only - E Massachusetts Permit No. BLDE-22-007340 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/N/NK OR TYPE ALL INFORMATION) Date:6/22/2022 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) 56 WILLIAMS RD Owner or Tenant Tim Grover 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: Add on A/C system. 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 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 ❑ 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 cc;c\-- J9( Kg fed. 73 , a • Commonwaa�tli el glassachscSetto Official Use Only r a 2epartmeni o/.Yira&,etcea Permit No. ��z.75'PO e '1.� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev,1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK AU work to be performed in accordance with the essachusetts Electrical C lole IVIE C,527 CMR 12.00 (PLEASE PRINT IN INK 0 L i Date: t/L. u City or Town of: 0 0" ector of Wires: By this application the undersign iv s notice of his or her ntention to perfor! the electrical or_k described below. Location(Street&Number) /iµ l� l7 1 p Owner'orTenant -`e.r w ,7 n Owner's Address elephone No. D 1 O7 j Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building ti (Check Appropriate Box) L `�'` Utility Authorization No._ Existing Service Amps t Volts Overhead —! L„i Undgrd Li No.of Meters New Service Amps / Volts Overhead ❑ Undgrd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: • Completion of the following table may be waived 6y the Inspector of Wires. No.of Recessed Luminaires No,ot'Ceil-Susp,(Paddle)Fans No,of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Lmninaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd, grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones • No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No,of Ranges No.of Air Cond. TotaTons! �j No.of Alerting Devices • No.of Waste Disposers Heat Pump Nnmbe Tons K No.of Self-Contained Totals: ....,. .,.................. Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ❑Other No,of Dryers Heating Appliances Key Security Systems:* No,of Devices or Equivalent No.of Water HeatersN0'of No,of KWData Wiring: Signs Ballasts No.of Devices or Equivalent No.I ydre:nassage Bathtubs biro,of Motors Total HP eiecommunicattons Wiring: No,of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Valu o Electr' al Work: (When required by municipal policy.) Work to Start: ` ,2--;Z 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 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 El (Specify:) I certify,at '----"at the information on this application is true and complete. FIRM NAI WAYNESCHMIDT ELECTRICIAN `� �E _ LIC.NO.: wlCr 222 Licensee: MARSTONSIMILLS,IC MADR02640 Signature LIC.NO.: (Ifappltcabl, • Address: (508)428.7747 Bus.Tel.No.: ^ - Tel.No.N—AjOIP *Per M.G.L. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt a c.No, 737 OS�/yI 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 ❑owner's agent. Owner/Agent Signature Telephone No. (PERMIT FEE:$ 'm`.