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Home My WebLink AboutBLDE-20-001051 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-001051 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 PRINT IN INK OR TYPE ALL INFORMATION) Date:8/26/2019 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) 163 CAPT NOYES RD Owner or Tenant NAVARRO NUNZIANTE R TRS Telephone No. Owner's Address NAVARRO CHARLOTTE R TRS, 163 CAPT NOYES RD,SOUTH YARMOUTH, MA 02664 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: Replacement furnace. 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 rnd. 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 ❑ 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 � � (z7/'? Cc' f-e,,R a- *5 6 CI<C)--a 1 -.=. - . l..ommonwea[th o f Massaehu et SO Use Only �� c� Permit No. ./�!_- = 2)eparfmant of Sirs�arvtcse i1 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION 'FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical ME 521CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: g , t q City or Town of: Y ARMOUTH To the Inspector of Wires: . By this application the widersi ed*es notice q�jS or h intention to perf. . the electrical work described below. Location(Street&N mber)_C_ CP ' I(i ,e (tLt% Owner.or Tenant f I Telephone No. Owner's Address -.C.. tin Jr- Is this permit in conjunction with a hui)ding permit? Yes No • \\`n ❑ (Check Appropriate Box) Purpose of Building 1 �3 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 • LoAfon and Nature of Proposed Electrical Work: (vim„ 1 u r lJ I�-c , .., Completion of the followinpitable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.nf Hot Tubs Generators KVA • No.of Luminaires Swimming Pool Above ❑ In- No.of I�;mergency Lighting grad grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners-7 No.of Detection and I Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump`Number I Tons No.of Self-Contained Totals:I Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW' Municipal p Local❑Connections' No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of No.o Heaters KWf Data Wiring: Signs Ballasts No.of Devices or Eq9uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Winn : - �l �t No.of Devices or Equiva ent OTHERititv 9 J' , `l�� y C - er Inspec__cotor of Wires. Estimated Value o Electrical Work: (When required by municipal policy.) Work to Start: ? 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 such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: Iiit BOND 0 OTHER ►� (Specify:) WO cK�^s C"' I I certify,under t"-- --'---- ---•y,that the information on this icatt n is ue and complete. FIRM NAME: WAYNE SCHMIDT ELECTRICIAN LIC.NO.:... Licensee: 222 WILLIMANTIC DRIVE Si nuts `� applicable,enteMARSTONS MILLS, MA 0264R g LIC.NO.: (If pP (508)428-7747 we.) Address: Bus.Tel.No.: '1—C)5-73Z2I'7i J `Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt LiTc.No..: � / ,- OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n�otmaliy S required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑o ' gent,__-Owner/Agent I Signature Telephone No. I PERMIT FEE: 1