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Home My WebLink AboutBLDE-22-001408 Commonwealth of Official Use Only E al Massachusetts Permit No. BLDE-22-001408 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:9/13/2021 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) 29 SKYLINE DR Owner or Tenant HABOSIAN MARY Telephone No. Owner's Address HABLANIAN ANN,22 ARDEN RD,WATERTOWN, MA 02172-1348 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace SEU to meter&upgrade grounding. 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- 1:1No.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 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. TotaloNo.of Alerting Devices 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 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens 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 my 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: $50.00 ftt • 'is CKG3 Lf9 • ammonrvsa&el di-_a rr/adtaceff3 '� t • �� ,.,• a a ao Only { Zeparicuml of e Servicedl Permit No. i�2-sr-- (e� g BOARD OF FIRE PREVENTION REGULATIONS ® � ancyand Poe Choked wank �, �z ' aPPLICaTIQN ' QR�PfiRMIT TO '� �Ya_.... ` ' PERFORM ELECTRICAL U. ; -- AU work to be peribr:acd in accordance with the Masoeahusette Monica!Coda WORK - G .) ,s (PLEASE PRINT IN INK OR TYPE.A ) ,sz7 CMR I Z.oO Lu -� .� City or Town of: OUT11 Date: 2 . By this application or the de 4 ±` N1� od: d : -s no,•e o h a r her mtention To the Inspector ofo ktWt esc o Location(Street&Number) p,, �perfor:n the electrical work described below. • l i m bwner'orTenant -• 1s Ilk �tr V\ ■ IRE Owner's Address Telephone No. Vara ar- is this permit In conlunotfon with a u d � e� �� mit? Yes __ _ - I'ttrp_se !'Building " - � � • � � (Check Appropriate Box) -Existing Service U� Utility Authot-fzation No, Amps .._.. Volts Overhead Undgrd[3 No,of Meters.„.S Ce Amps --.-_.L,Yolts Overhead ?Maher of Feeders and Atnpaoity ❑ Undgrd❑ No.of Meters Lo tiop a d Nature •.f Pr.nose, • SUt r J, _ rk: • J � lestrl al'VPO No.of Recessed LuminairesCora•lettan a the afloat' table hs, be waived, the Ins.actor o Wires. No.of CeU..$usp.(Paddle)Fans o.o` No,of Luminaire Outlets Traf' era KVA • No,of Luminaires No.of Hot Tubs • Striatming Pool ,rude ❑ rt- '. ' merge, g n No.of Receptacle OaUets d. Batts Units g No.of Oil Burners No.of Switches --- FMB ALARMS No.of Zones +�.� -o.o :.:. :on aa. No.of Ranges - �•• ' Ynttfatin , • Na of Air Cond. No.of Waste Disposers Tons No.of Alerting Devices - -" Aatectio• Ale" a Devices No.of Dishwashers Space/Area Heating KW' 'un _. No.of Dryers Heating Luca!Ci Connection 0��' `o.o �'a er Appliances KW ,ecu S ins: ' Heater: + ,o.o. No.of o ul evtces valet+t ;ns '0.0 is Data Wiring: Na hydromassage Bathtubs No.of Devices or E•ulvalent No.of Motors Total HP a ecomman at ons ragg OTHER: No.of Devices or ' • •iva-lent Estimated Val� f „ , • odd Attach addtitonal detail doer red as required by the inspector of Wires. Work to Start: Ha, (When required by municipal policy.) Work t INSURANCE o.T ' • GE: Unless waived Inspeetiona to be requested in accordance with MEC Rule 10,and upon completion• the licensee provides proof of liability insurance teO "completed o Y owner,no permit for the performance of electrical work mayis undersigned certifies that such coverage is in forceincluding p peradon"coverage or its sabstantial equivalents unless CHECK ONE: INSURANCE BOND ,and has exhibited proof of same to the permit Issuing office. I jy,ander cN---,--_ - .r ---"-- r...,. • d OTHERS b t ers WAYNE9CHMIDT .-7,that the inform,. on eh , ;, a ,rr FIRM NAME. ELECTRICIAN ' and c rnpletG Licensee: 222 WILLIMANTIC DRIVE ! �; LIC.NO.: E ,:qt (UpPPlecoble'en MARSTONS MILi,$ MA 02648.....,Slgnatu� , .1S--_, Address: (808)428' 747 'na) LIC.NO.: J '"per M.O.L.c, 147,s.57-61,security Bus.Tel.No.. INA' - t9 i~7 INSURANCE WAIVER: work requires Department of public Safety"$"License: Alt.Tel.No.: -'•1 j"'.l <I / 1GreOWNER'S law. ByIVER: Ian:aware that the Licensee does not have the liability insurance coverage n t Owner/Agent my signature below,I hereby waive this requirement. I am the(cheek one owner !t ormally '�) Signature ��"" ' ...Tetenhone No. =_- owner's a enc PF.Rnerr vial. e