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Home My WebLink AboutBLDE-19-000817 Cor ommonwealtof OffimalUseOnly f Massachusetts Permit No. BLDE-19-000817 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.1/071 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 ININK OR TYPE ALL INFORMATION) Date:8/10/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pert tom the electrical work described below. Location(Street&Number) 5 WHISTLER LN Owner or Tenant RILEY PATRICIA A Telephone No. Owner's Address 109 BROAD ST APT 605,WEYMOUTH, MA 02188 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ 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: Split NC. 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 0 In- ❑ .No.of Emergency Lighting rnd. 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 Data Wiring: Heaters Mans Ballasts 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 ❑ BOND 0 OTHER ❑ (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"5"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) 0 owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 Sia 614t t' ftc�1 0KGY . l.ornnrwame.Gh of rr/auachrxfG Official Use Only I'4 c7� �a Permit No. Cha 0 1 . A 2erarlaunl of Jin Jersicd ilii Occupancy'and Fee Checked '.' " BOARD OF FIRE-PREVENTION REGULATIONS [Rev.1/07j (leave blank) • - APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be patterned in accordance with the Massachusetts Electrical5`27�/CMR 12.00 (PLEASE PRINT IN INK OR ' . �LL INFO' I .i Date: 6 1 h City.or Town of: a u0 Al, To the Inspector of Wires: By this application the undersigned -. on' of his at ha mai t. • onn the electrical work described below. ?' Location(Street&`Number) • I sal-er ' i • V OwnerorTenant l_a' An.° (t ' L Telephone No. van Owner's Address • f Is this permit in conju io with a buil it? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorisation No.. Existing Service "• Amps • / Y Overhead❑ - Undgrd 0 No.of Meters • New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity • Location and Nature \ooff�Proposed Electrical Work: n /u�■ wa S\EKP Complufon ofThefo/lowfngtable may be waived by the InspeaorofWier. No.of Rfcessed Luminaires No.of Celt-Sam.(Paddle)Fans No.of Total • Transformers KVA • • No.of Luminaire Outlets No.of Hot Tubs Generators, KVA No.of Ldminatra • - Swi • - -Above In-- No.of Emergency iagaung t . Swimming Pool. grind. Q Prod. ❑ Battery Units '\ ' No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones • - No.ofSwitches No.of Gas Burners No.ofDetecnon and Initiating Devices No.of Ranges No.of Air Cond. purl No.ofAlerting Devices No;of Waste Disposers Heat Pump Numbe ons KW No.of Self-Contained Totals: Detection/Alerting Devices . No.Of Dishwasher Space/Area Heating KW Local E Mimidpal 0 Other Conrieetion No.of Dryers Heating Appliances Kwr Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: • Signs Ballasts No.of Devices or Equivalent • No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wlring No.of Devices or Equivalent OTHER: Attach additional detail ifdrsired oras required by the Inspector of Wires. Estimated Value o EI tric(((a'l Work: (When required by municipal policy.) Work to Start /) f i 9• Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COV ERAG Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability instance 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: INSURANCEX .BOND ❑ OTHER ❑ (Specify:) I certify,ur - - ' ' the information on this application is true and complete.- no Ai FIRM NAI WAYNE SCHMIDT ��ii LIC NO.: 1 ELECTRICIAN I accuser 222 WIWn MANTIC DRIVE SlgnatnLIC.NO.: (Ifapplimbb • (50 MAR MILLS,MA 02648 'wC!_21/1 (508)428-7747 Bos Tel.No: • Address: • Alt.Tel No *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)❑owner ❑owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.