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Home My WebLink AboutBLDE-19-005101 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-005101 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:3/11/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to p colm e electrical work de ri d bele i. p Location(Street&Number) 19 BENNETT AVE L.—-3+ ?�, 6� Owner or Tenant ODONNELL MARILYN A Telephone No. Owner's Address 85 SAINT AGATHA RD, MILTON, MA 02186-4336 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 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Air cond. System (Attic) Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- o 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 No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices Space/Area HeatinLocal 0 Munici al No.of Dishwashers P g KW Connection 0 Other: HeatingAppliances No.of Dryers PP 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 Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 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 lel ' 11cf--- ' '` Cnunorsteea[th off Madiaekuieth �Ofcial Use Only _'f Permit No. ( 'fiCI '15 ( 0 k ot _.7.= t ,ar w�"f al..Ju-e Servicess Occupancy and Fee Checked ' - " BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ATI work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12.00 (PLEASE PRINT IN INK OR 77PALL INFORMA ON) Date: I d City or Town of: l1 Y'-O U To the ns ector of Wires: By this application the undersign gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) l C 13 e r n.e 1- P y l Owner-or Tenant CA ' ` 3 N.e_jJ,e l Telephone No. -C12:-45.74._ Owner's Address -"` Is this permit in conj etion "th iiding permit? Yes p No (Check Appropriate Box) Purpose of Building r)1 J ` A_ _ ---_ Utility Authorization``` ``` No. Existing Service Amps - / olts Overhead❑ Undgrd❑ No.of Meters New Service Amps I Volts Overhead❑ Undgrd f No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (AC)'`r-c, Pr- I • 1 Ci h-c-l ........_ (5. 3 5qc Completion of the olio table be waived the Inn oro -W d f by peer f ries. No.of Recessed Luminaires No.of CeiL-Seip.(Paddle)Fans NO•of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA AboveIn- fie.of emergency Lighting No.of Luminaires - Swimming Pool Q Q grad.- grad. Battery Units No.of Receptacle Outlets No.of Ont Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and InitiatingDevices No.of Ran k Total ges No of Air Coad. Tons9._ Na of Alerting Devices No.of Waste Disposers Heat Pump Number Tons ICW No.of Self-Contained Totals: Detection/Ales:tint Devices . No.of Dishwashers Space/Area Heating KW' Local❑ Municipal VV No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of WaterKW No.of No.of Data Wiring: Heaters Signs Ballasts � No.of Devices er .quivatent No.Hydromassage Bathtubs -No_of Motors Total HP Teiecommnalcatronsitag: No.of Devices or Equivalent OTHER: Attach additional detail if desired.or as required by the Inspector of Wires Estimated Value of Ii. tric. Work: (When required by municipal policy.) Work to Start: t gly Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE I ERAG : less 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 [) OTHER 0 (Specify.) I certify,us - . . 'iai the information on this application is true and complete. 33 FIRM NAI WAY EEC SCA1C AJq T LIC.NO.: rt., � ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE Signature LIC.NO.: lu abl. MARST(50 MILLS, 47 02648 ` 2.171(If app (508)428-7747 Bus.Tel.No.: iiir 7 J 1 Address: Alt.TeL No.. /..j[ *Per M.G.L.c. 147,s.57-61,security work requires Department of-Public Safety"S"License: Lie.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/AgentPERMIT'FEE: $ O Signature Telephone No.