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Home My WebLink AboutBlde-20-002807 Commonwealth of Official Use Only Permit No. BLDE-20-002807 /Oft Massachusetts 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:11/14/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 81 NIGHTINGALE DR Owner or Tenant BAHMAN SUSAN D Telephone No. Owner's Address 81 NIGHTINGALE DR, 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 grnd. grnd. Batten,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 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:$50.00 t,\ 14c,0, ,ke____ c << f 2(19 50 G G- Commonwealth // Official� Use Only !�(,,) Cpmmoncvealth o` a�achuseft! W v�tJ`' -- Permit No. 7 �` —;t c�r� c7 .,_= i= ; 2)eparfinen1o`..tire�ervice$ — . Occupancy and Fee Checked • 'r. . BOARD OF FIRE PREVENTION REGULATIONS [Rev. (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical a 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORW\Old Date: I I ►S I q City or Town of: 'o U To the Inspector of Wires: - By this application the undersigned'ves no• e f his or her intentio to perform the electrical work described below. Location(Street& umber) 1 4 r Owner-orTenant \c___, 1 Telephone No. -- Owner's Address Is this permit in conju ion with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building '`e,�\ % n Utility Authorization No. Existing Service Amps • / Volta' Overhead❑ Undgrd❑ No.of Meters New Service Amps I Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: w ` F,e_pl,...141--c-e r1-e_KA Completion of the followin&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 Above In- No.of Emergency Lighting • No.of Luminaires Swimming Pool grnd. ❑ grnd. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices ° No.of Alerting Devices No.of Ranges , . • • ° ' :. Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Detection/Alerting Devices . Municipal ' L No.of Dishwashers Space/Area Heating KWocal❑Connection ❑ Other ,• Heating Appliances KW Security Systems:* No.of Dryers 1�o.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 desirec4 or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Li ( I Li,l Ci 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 cov :ge 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, n, of perjury,that the inform ' n.on this ,d' r ation true and complete. 3 rneyCOP { 1 FIRM NAME: WAYNE SCHMIDT LIC.NO.: �ii ELECTRICIAN Or_Signature i LIC.NO.: Licensee: 222 WILLIMANTIC DRIVE g (If applicable.enle.MARSTONS MILLS,MA 02648 Bus.TeL No.: O �' 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 0 owner's agent. Owner/Agent — I PERMIT FEE:$ Signature Telephone No.