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Home My WebLink AboutBLDE-20-002387 Commonwealth of Official Use Only - P Massachusetts Permit No. BLDE-20-002387 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:10/28/2019 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) 122 CAPT NOYES RD Owner or Tenant CASTAGNETO LAWRENCE J(LIFE EST) Telephone No. Owner's Address C/O DIANE JOHNSON, 24 CARLSON ROAD, MILTON, MA 02186 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 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. ,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/Alerting 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 0 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 c g ( I eq : 2 k6--- _ojic--9___"- r //��omnwnweaUl&//� o`'V///iiiaSsacQU. Official Use Only L_ ** _it cc%�� Permit No. =�'= J)eparfinenl o/ ire)erurcei _ I`_a Occupancy and Fee Checked r=4 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) r APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 52 CMV I�.00 (PLEASE PRINT IN INK OR P ALL INFOR ION) Date: City or Town of: � 0�� To the Inspector of Wires: � � By this application the undersign 'vasnes notice of his or her\intention to perform the electrical work described below. Lo 'on(Street&Number) ,f� �0- NO S S`�V�(' � � Owner r Tenant �6-1,(�� CYO 1ti 11 SCI'I Telephone No. ` it Owner's Address Is this permit in conjunction with a building permit? Yes ❑ Noo (Check Appropriate Box) ` Purpose of Building D AJ-e X\ \A Utility Authorization No. Existing Service Amps / Volts Overhead❑. Undgrd U No.of Meters New Service Amps / Volts Overhead❑ Undgrd n No.of Meters Number of Feeders and Ampacity L catio �n and Nature of Proposed Electrical Work: (Ji I _ e pA_ .L iii-� G- ig- (1Le Completion of the jollowing_table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tf KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting • grnd. grnd. Battery Units No.of Receptacle Outlets w rn_ ,er`; FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.o rA r con . Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons ,KW.... No.of Self-Contained P Totals: — Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW' Local❑ Municipal ❑ Other PConnection No.of Dryers Heating Appliances KW Security Systems:* rY No,of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent - romassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: -Nu.H Yd h No.of Devices or Equivalent OTHER: - Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of E ectri 1 Work: _ (When required by municipal policy) Work to Start: 1 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO GE: 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 ❑ OTHER ❑ (Specify:) - • I certify,under the pains and s of Perjury,that the inform don,on this rd."ation true and complete. ? //'' FIRM NAME: WAYNE SCHMIDT � 222 WILLIMANTIC DRIVE g ' LIC.NO.: E3JIDq� Licensee: ELECTRICIAN -Signature 1 LIC.NO.: (If applicable,ente.MARSTONS MILLS, MA 02648 Bus.Tel.No.: 7 . Address (508)428-7747 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 Signature Telephone No. PERMIT FEE:$ L