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Home My WebLink AboutBLDE-22-006598 k\ik Commonwealth of BLDE-22-006598 Permit No. Official Use Only � ' Massachusetts °i-a.:, 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:5/17/2022 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) 73 HAZELMOOR RD t®' D, 5t6e-— 3 6 Z,o Owner or Tenant BENOIT JAMES F Telephone No. Owner's Address BENOIT ALLISON J,2 PHEASANT TRAIL, HUDSON, MA 01749 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 ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Attic 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 Heat Pump Number Tons KW _No.of Self-Contained No.of Waste Disposers 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 Eouivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eouivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eouivalent 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 i t10,-C. CIS'<2,_ • Commonwealin of ttladdacAidelid Offcial Use Only /j 5• III s1'-pit C.Z2.-ir+ e ariment o/cC77 p _�_,. � �p .}Ira Smoked Permit No. �� _ `f' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev,1/07j peeve blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the assachusetts Electrical Code C),527 CMR 12.00 (PLEASE PRINT IN INK O L Date: City or Town of: • To the Inspector of Wires: By this application the undersi n fives notice of his or her ntention to pert ct 2e electrical work described below., Location(Street&Number)_ Z Z l t,�D f r7 A J Owecr'or Tenant -- --_--- tY below. _ Pr�1�S I e_vUtT- Telephone _�=t_ Owner's Address ' l-5 i3c.Z 1 Is this permit in contu�lion with a hnilding permit? Ye_ no (cheek Purpose of Building ,�J`, e "t< Gq e ❑ 't io No.Apprcpriata gcx) ,']V Utility Authorization Existing Service Amps • / olts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead Undgrd Number of Feeders and Ampacity 0 ❑ No.of Meters Location and Nature of Proposed Electrical Work: ,�1i C_ � C�/S le ill L v/J— Completion of the following table maybe waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No,of rninaire OutletsTransformersTotal VA . No.of Lu KVA No,of Rot 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 JNo.of Zones No,of Switches No.of Gas Burners ue..,.1d' , 'No.of Detection and No,of Ranges Total4Jl> Initiating Devices • No.of Air Coed. Tons "1J�PL— No.of Alerting Devices Na,of Waste Disposers Heat Pump Number Tons,,,,•,,, KW No.of Self-Contained Totals;1...... L.. l.K..,,,,•.,........ Space/Area floating Devices No.of Dishwashers p KW' Local D.Mmdcipal Connection0 Other No,of Dryers Heating Appliances KW Security Systems:* No.of Water 'No. of Devices or E.uivalent seaters KW of ol.00f— n .-W:,• Signs Ballasts ma-: No.of Devices or Equivalent • No.Hydromassage Bathtubs No,of Motors Total HI' Telecommunications Wiring: OTHER: No,of Devices or Equivalent Estimated Valued le rical Work: Attach additional detail if desired,or as required by the Impostor of Wires. (When required by municipal policy.) Work to Start: ZL.— Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE GE: 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 0 OTHER 0 (Specify:) I certify,at •.•' ."'lot the information on this application is true and complete,WAYNE SCHMIDT FIRM NAI pP ELECTRICIAN `T t A LIC.NO,: "Licensee: MARSTONS 1MILLS,IMA R0264S(Ifappltcab%� SignatureL-,��° � LIC,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: Alt Lic.No. �� OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally requiOwner/Agent wner/ g law. By my signature below,I hereby waive this requirement, lam the(check one ❑owner [�owner's agent, Ownrrd by a"en Signature Telephone No. PERMIT FEE:$