The URL can be used to link to this page

Home My WebLink AboutE-20-1737 0 0. Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-001737 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:9/30/2019 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 belo Location(Street&Number) 74 TROWBRIDGE PATH g— • 02- (m$ Owner or Tenant GAGE GLORIA L Telephone No. Owner's Address 74 TROWBRIDGE PATH,WEST YARMOUTH, MA 02673 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. 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ 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 ❑ 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 ON) E f•-E; CMG- �� • lrommoruusalth o/Madeac ltl fficial Use Only - 1 eparimant opine Serviced Permit No. f= f 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 C C 52 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: lc( City or Town of: YARMOUTH To the Inspector of Wires:By this application the undersigned gives notice of his or her int 'on to perform a elec 'cal work described below. Location(Street&Nu ber) / Owner'or Tenant . 0 r c •�; Telephone N W; Owner's Address s / Is this permit in conjunction with a bui ding permit? YesNo -_ - - - - 0 ;, (Check Appropriate Box) Purpose of Building ' W��\ n — Utility Authorization No, Existing Service Amps / Volts Overhead Q, Und grd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd g ❑ No,of Meters Number of Feeders and Ampacity Lon and Nature of Proposed Electrical Work: • Fi r i ?-e131..._ere._e_rite,h. . 4 • Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ced.-Susp.(Paddle)Fans No.of Total Transformers KVA _ No.of Luminaire Outlets No.lof Hot Tubs Generators KVA • No.of Luminaires Swimming Pool Above In- (No,of 1mergency Lighting grnd, _grnd, Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No,of Zones No.of Switches CNo,of Gas Burners o.ofDetection and Initiating Devices To No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Coained Totals: I nt Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW' Municipal ' Local 0 Connection 0 Oth� No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters __ KW _ No,of Data Wiring: sins - — 13allaslf 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 Val • : ; ' / j di; Work (When required by municipal policy.) Work to Start: i�J 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 X BOND ❑ OTHER X(Specify) WO cKerS SZomp I certify, under t'---'-----1--_'-.-' -_�FIRM NAME• WAYNE SCHMIDTthat the information on thislete:� �� ELECTRICIAN LIC.NO.:"�V + i v-/q Licensee: 222 WILLIMANTIC DRIVE —MARSTONS MILLS, MA 02648._._.Signets LIC.NO.: (If applicable,ente (508)428.7747 'ne.) Address, Bus.Tel.No,: / •/ J *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt Tel.No.: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance nce coverage n— ormally required by law. Bym signature S Owner/Agentedbyla y below,I hereby waive this requirement. I am the(check one 0 owner 0 owner's a:ent. Signature al Telephone No. PERMIT FEE: $ 4.1