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Home My WebLink AboutBlde-20-000797 or Commonwealth of Official Use Only -E- Massachusetts Permit No. BLDE-20-000797 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:8/12/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice or his or her intention to perform the electrical work described below. Location(Street&Number) 300 BUCK ISLAND RD UNIT 1C Owner or Tenant FAICHNEY ROBERT J Telephone No. Owner's Address FAICHNEY DEBORAH J, 10 FOREST RD, MEDWAY, MA 02053 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 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: Replacement A/C conden # 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 Agrbbove ❑ In- ❑ No.of Emergency Lighting ia 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 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 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 f€ D. C1G. a 1.,g•CI �• �t / Official Use Only t�v�nrnoRareatth a aac a7 i c� Permit No. 7 ., .. C��- , ' 2)sparbna c��']ai al giro&rviced • cr ' Y• Occupancy and Fee Checked .. • BOARD OF FIRE PREVENTION REGULATIONS (Rev. I/07j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical .527 CMR 12.00 (PLEASE PRINT IN INK OR ' ALL 1 OR •N) Date: City or Town of: n �' I. To the Inspector of Wi es: _ By this application the undersi ned , �e of is or h latest io,o,'erform the electrical wor • h ibed below. Location(Street& mb r) l I ! I ILIA � Uh • ,- 9 �r t- Owner•orTenant ;, I WOOL I. Teleph. No vrdAIMZ' r.!4 Owner's Address ••-‘ Is this permit in conjunct on with skIntilding permit? Yes 0 No (Check Appropriate Box) -- ----Purpose of BnildingD_ ---- - Utility Athorization No. Existing Service Amps • / Volts Overhead❑. Undgrd❑ No.of Meters • New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Natur of Proposed Electrical Work: (JO [ tt 1:2...:VICC). A'd 11:1}-e— `SCrt Completion of thefollowin: table may be waived by the Inspector of Wirer. No.of Recessed Luminaires No.of Cell.-S (Paddle)Fans No.rnos Total �P• Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA . • •Above rrt In- No.of timergency Lighting ' No.of Luminaires Swimming Pool. grad.• grad. 0 Battery Units • No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burn rs No.of Detection and initiating Devices 1 Tot No.of Ranges No.of Air Cond Tons No.of Alerting Devices No.of Waste DisposersHeat Pump INum r_Tons_ W-_ No.of Self-Contained Totals:` • M Detection/Ale tiny Devi ces• No.of Dishwashers • Space/Area Heating KW' L l❑Ce nnettioeipat ❑ Other, C4nnectIon 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 No1of Devises or E.uivalen_t •_ , dr• . assage Bathtubs No.of Motors Total HP Telecommunications firing• No.H y g No.of Devices or Equivalent OTHE0 S �f�S D1 • !� Attach additio al deta if desired,or as required by the Inspector of Wires. Estimated Value o EI teal Work: (When required by municipal policy.) Work.to Start: _ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE 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 co erage is in force,and has exhibited proof of same to the permit issuing office._ CHECK ONE: INSURANCE .BOND 0 OTHER 0 (Specify:) I certify,us • ' -tat the Information on this application is true and complete. �2 r FIRM NM SCHMIDT LIC.NO.: ✓i J n ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE Signature W LIC.NO.: a licabl- MARST(50 MILLS, 47 02648 Bus.Tel.No.:109 7727 t7l PP (508)428-7747 �]]�� `..11�,• Address: Alt.Tel.No.. J elo� i *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)0 owner 0 owner's agent. Owner/Agent SignaturePERMIT FEE:$Telephone No. .----j