The URL can be used to link to this page

Home My WebLink AboutBLDE-19-001336 N.So ?%y►ra. � Commonwealth of OfficialUse Only st_.�7`,�' Massachusetts Permit No. BLDE-19-001336 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 (PLEA SE PRLVTIN INK OR TYPE ALL INFORMATION) Date:9/4/2018 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) 14 STRAWBERRY LN Owner or Tenant WILLIAMS BENJAMIN J JR TRS Telephone No. Owner's Address C/O PERERA JOAN, 13 BIRCHWOOD LN.LINCOLN, MA 01773 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 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: Replacement boiler. • 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. Batten,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 Initiative Devices No.of Ranges No.of Air Coml. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump _Number Tons KW__ No.of Self-Contained Totals: DetectionlAlertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 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 Slens 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 0 BOND 0 OTHER 0 (Specify:) 1 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 Mt.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 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 04 1f t iiBt �.cer - G kC-w t-ammonweallh o`Massachusetts - Official(alUse Only cy' �c77 ��7a Permit No. CZ CI ' (�G Pm Theparlmenf of lire-.cervices . ;1 Occupancy and Fee Checked • BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code �Cry).5 7 CM�R/12.00 (PLEASE PRINT IN INK OR ' ALL INFOR ION) Date: tIc b City or Town of: r 'Q(/ To the Inspector of Wires: . By this application the undersign . :'res not e . is or h r intention to perform the electrical work describ-. belo . Location(Street&Number) f • Ir\ 'Q{ a �— OwnerorTenant 3 ,� P •- .('P. Telephone N5cg " i 7��ry�7I1 Owner's Addresstt1t W_i?Pt') . LdJ Is this permit in conjunction with a building permit? Yes ❑ No* (Check Appropriate Box) . - Purpose of Building t)W-e' A,\ \A Utility Authorization No. Existing Service_ Amps _ / Volts Overhead❑ Undgrd El No.of Meters New Service _ Amps / Volts Overhead❑ Undgrd ❑ Ne.of Meters Number of Feeders and Ampacity Locationand Nature of Proposed Electrical Work: ( T tI cpL,P Imlay & r}. Completion of thefollowing_table may be waived by the Inspector of Wirer. No.of Recessed Luminaires No.of Ce6.-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. Battery Units • No.of Receptacle Outlets No.of OH thinners FIRE ALARMS No.of Zones No.of Switches • No.of Gas Burner No.of Detection and ��/ Initiating Devices No.of Ranges No.of ArrCon& °taI No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained P Totals: Detection/Alertingpevices • . No.of Dishwashers Space/Area Heating KW' Local Municipal No.of Dryers Heating Appliances KW Ses:* curity of Devices or Equivalent ' • is o,of WaterKW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Eqquivalent No.Hydromassage Bathtubs No.ofloyief-- Lek Motors T• HP Telecommunications Wiring: 7i;e; No.of ces or uiva e t(OTHER: �� Attach additional detail iifderirect or as required by the Ins tor of Wires. Estimated Vallee caal World (When required by municipal policy.) • Work to Start: 1, 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 suchcoverage is in force,and has exhibited proof Of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) - I tenth',under the pains and na es of perjury,that the Inform tion on this 1' ation true and completu'3^S GiR • FIRM NAME: WAYNE SCHMIDT fr-] LIC.NO.: 7 Licensee: ELECTRICIAN Signaad 222 WILLIMANTIC DRIVE _ g lure LIC.NO.: . (Ifapplieable,erne.MARSTONS MILLS, MA 02648 , Bus.Tel.No:�O!/ 737917/ Address. (508)428.7747 Alt Tel.No.: ly *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 0 owner's agent Owner/Agent Signature Telephone No. PERMIT FEE: $