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Home My WebLink AboutBLDE-22-003153 Commonwealth of Official Use Only IAMassachusetts Permit No. BLDE-22-003153 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:12/2/2021 City or Town of: YARMOUTH To the Inspector of Wit : By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 32 MARGARET JOSEPH RD Owner or Tenant Roberta Haeberle Telephone No. Owner's Address 32 MARGARET JOSEPH RD, YARMOUTH PORT, MA 02675-2455 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 ❑ Undgrd 0 o f�'ieters New Service Amps Volts Overhead 0 Undgrd 0 l if Tete Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement boiler. fff a ` 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 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Ton l 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 0 Municipal Connection 0 Other: 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 Siens 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 -Ft( SD— GKCL • _ -\ Commonweal/4 of///amac�effa Official Use Only i. '- i_ft cc�� Permit No. Z�j I�5 =rt_ 2eparfinenl o/3ire�ervice! =`i1- Occupancy and Fee Checked Yr `='i BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) Jr APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Cod ) 5 A., 12.00 (PLEASE PRINT IN INK OR P ALL INFOR 10N) Date: l 1 City or Town of: 010 � To the Inspector o Wires: By this application the undersigne 'ves notice of his or her intention to perform the electrical work describedc below. Location(Street& umber). ." k k 1 U U� �j/�._ Owner•or Tenant Telephone No.�3 L— !(�_.33 Owner's Address . �,r Is this permit in conjunction with a building permit? Yes ❑ No ffi (Check Appropriate Box) Purpose of Building D i .)-e_`,\ \A Utility Authorization No. • Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity � ,- Lcall o and Nature of Proposed Electrical Work: (_, �1 , ]C YO ..L . ._e 1-e p vk....j.._ G-1J Completion of thefollowin&table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Sus .(Paddle)Fans Tf al P Transformers K KVVA 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 riper s; FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners ` • No.of Detection and Initiating Devices No.of Ranges No.o it Lond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices _ P No.of Dishwashers Space/Area HeatingKW' Local❑ Municipal ❑ Other P Connection • No.of Dryers Heating Appliances KW Security Systems:* r Y No,of Devices or Equivalent . No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.H drornassa a Bathtubs No.of Motors Total HP Telecommunicationso fDevices orWiring:ql Y 1; No.of Devices Equivalent OTHER: • Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Valui E ec ork: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO ERAGE: 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 cov rage is in force,and has'xhibited proof Of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify:) . I certify,under the pains and na es of veriurv,that the inform Lion,on this wpl'i ation s true and complete 3 FIRM NAME:_ WAYNE SCHMIDT � - LIC.NO.: �� f Licensee: ELECTRICIAN Signature 1 LIC.NO.: 222 WILLIMANTIC DRIVE g r (If applicable.ente.MARSTONS MILLS, MA 02648 Bus.Tel.No.: O� � ��' Address: (508)428 7747 Alt.Tel.No.: U *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.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)El owner ❑owner's agent. OwnerfAgent Signature ~—'—' Telephone No. — PERMIT FEE: $ _SO