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Home My WebLink AboutBLDE-19-002501 Commonwealth of Official Use Only Massachusetts PetmitNo. BLDE-19-002501 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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 PR/NT/NEW OR TYPE ALL INFORMAT/ON) Date:10/29/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertonn the electrical work described below. Location(Street&Number) 71 CRANBERRY LN Owner or Tenant KELLEY HOWARD W Telephone No. Owner's Address KELLEY BARBARA J, 71 CRANBERRY LN,SOUTH YARMOUTH, MA 02664-1007 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 ❑ No.of Meters New Service Amps Volts Overhead ❑ 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 PoolAbove ❑ In- 1:1No.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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons 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 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 Signs 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"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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 �� l0/Z48 ck feemG- ,�C L.ommomon&o f Wassac/wdetfi Official/�U,se O�nly(—/M — Permit No. 'e q— V` =�yt_ c]� �7 �i .e apartment of }ire Jervied .• 4(= ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07] " (leave blank) APPLICATION FORPERMIT TO PERFORM ELECTRICAL WORK MI work to be performed in accordance with the Massachusetts Electrical CodeC),5 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIONS Date: 10 � 7/ 1 City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersigned gives notice—of his or her intention to perform the electrical work described below. • Location O (Stmt& i -ttbec) dG ��jt flA L^f on \o. e Owner Or Tenant .LLU{llhi.,l.-Y�G-Iy -/�� `J t 1, Telephone No. � Owner's Address s /-ypl1.1C---- Is - ` Is this permit in conjunction with a bu'ding permit? YesNo r �� 0 (Check Appropriate Box) Purpose of Building D w \Yk3 Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Und rd g 0 No.of Meters Number of Feeders and Ampacity e • Loon and Nature Pro.osed Electrical rid 0• i tic..-_ Completion of thefollowinqtable 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 rn In- No.of Emergency Lighting• Erniantd. O Battery Units No.of Receptacle Outlets . No.of OR Burners FIRE ALARMS JNo.of Zones No.of Switches CNo.of Gas Burners I No.of Detection and Initiating Devices To No.of Ranges No.of Mr Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number tions I KW No.of Self-Contained Totals: ! Detection/Alerting Devices No.of Dishwashers • Space/Area Heating KW- Local0 Municipal Connection El Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No. of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: �{+� '4 �^ ,_, 1 No.of Devices or Equivalent OTHER: CUSTdrner u,FS Q Uiaq YtIW` Si vl Q 13-1—c i Attach additional detail ifdesire4 or as required by the Inspector of Wires. Estimated Valuer1 oElectrical Work: (When required by municipal policy.) Work to Start:hU Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VERAGE: 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 Xi BOND 0 OTHER X(Specify:) WO C Kers COVNT I eerhfy, under t`---`-•- ---1---"-- -r-- WAYNE SCHMIDT Y,that the information on this icon xis true and complete 222 �� FIRM NAME: ILLIMANTAN � 1 O L LIC.NO.:� �� Licensee:—MARSTONS MILLS,IC DRIVE MA 02648__Si gnatu a ✓ LIC.NO.: (If applicable,este : (508)428-7747 - 'rte.) Bus.Tel.No:�°[p J � 7/ Address: dresr. Alt.Tel.No.: j Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. Q OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage nrmally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent Owner/Agent j Signature Telephone No. 1 PERMIT FEE: $ l