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Home My WebLink AboutBLDE-21-005049 Commonwealth of Official Use Only L. kt - Massachusetts Permit No. BLDE-21-005049 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:3/8/2021 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) 23 HASTING AVE Owner or Tenant REISER MARY E Telephone No. Owner's Address MONTEITH WILLIAM D,23 HASTING AVE,WEST YARMOUTH, MA 02673-2634 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service l Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and pacity Location and Nature of Ptkoposed 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 p Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KWtems:* No.Securityof Devicesor Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 1ZR/uety c..ecal _ec„ G k3 - Commonwealth 1 -3_51- oi�//////a �ac�fh Official Use Only ��— ��^� ,,-'*-`=ft cc�� c7 {� Permit No. O n-.lit rL)e artment o/Mire Services �_.v P Occupancy and Fee Checked t_i•= Y. 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 Code(ME ,527 CMR 12.00 (PLEASE PRINT IN INK OR P ALL INFOR ION) Date: 3 151 1 City or Town of: U t To the Inspector of Wires: - By this application the undersign gives notic o his or her intention to perform the electrical work descrribed below. Location(Street&Number) �- 1-1 Vik. N"-V t-:- ' 1 f Owner.or Tenant PI-cc) \ e ‘se 9- Telephone NoTg" f,. — 6 Owner's Address X Is this permit in conjunction with a uild_ing permit? Yes ❑ No (Check Appropriate Box) Purpose of Building D t,,�-e ,V \ Utility Authorization No. Existing Service Amps - / Volts Overhead❑. Undgrd El No.of Meters New Service Amps / Volts Overhead❑ Undgrd n No.of Meters Number of Feeders and Ampacity n L cation and Nature of Proposed Electrical Work: (J I`'c, iZe f LL�ce pi..e,✓t G-f • -�I Le Completion of the following.table may be waived by the Inspector of blues 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.o 't H,ir me FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and No.of Switches ' Initiating Devices Tota No.of Ranges No.o it ond. Tons No.of Alerting Devices • Heat Pump Number_ Tons KW No.of Self-Contained No.of Waste Disposers Totals: �— Detection/Alerting Devices No.of Dish rashers Space/Area Heating KW Local Q Municipal Connection ❑ Other Heating Appliances KW Security Systems:* No.of Dryers No,of Devices or Equivalent No.of Water o.of KW No.of No.losts Data Wiring: Heaters Signs 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 desirecl or as required by the Inspector of Wires. Estimated Va1u f Electrical Work: (When required by municipal policy) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C. 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,:xhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and,l 'Ities of penury,that the inform don on this pi' ation true and complete. 3 6 FIRM NAME: WAYNE SCHMIDT LIC.NO.: � { ELECTRICIAN NO.: Licensee: 222 WILLIMANTIC DRIVE -Signature LIC. (lfapplicable,ente.MARSTONS MILLS, MA 02648 , Bus.Tel.No.• .07/ 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)El owner ❑owner._ ent. Owner/Agent - PERMIT FED:$ Signature Telephone No.