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Home My WebLink AboutBLDE-21-002569 Commonwealth of Official Use Only r,Ay Massachusetts Permit No. BLDE-21-002569 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:11/5/2020 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) 15 GLENWOOD ST Owner or Tenant OFFICER JOHN DAVID Telephone No. Owner's Address WADE MARCIA J,60 SUTTON PLACE SOUTH, NEW YORK, NY 10021-4168 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check •propriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 Po4161P..*New Service Amps Volts Overhead ❑ Undgrd ❑ N Number of Feeders and Ampacity0:1)0 011 Location and Nature of Proposed Electrical Work: Replacement furnace. ' , ctor Wires. Completion of the following table may be �, .- �� of No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of I al Transformers • A 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/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 o E• ai No. romassa H d a Bathtubs No.of Motors Total HP Telecommu I •s' •f y g No.of Devi • • r" iva t 40 OTHER: \ Attach additional detail if desire , r i 1 b spector 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 li.-•,g provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies ,t coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) 441--- 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 Qiiiir 14/( (z Fe_e=;._._Z____,, ��-1(.r. Commonwealth o`///addac/.a ett. Official Use Only -kt` c� Permit No. --Z' rcg -./f�- = 2apartmeni of�iro Serviced �_- si 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 Code C),52 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ` 1 3 J City or Town of: YARMOUTH To the Inspector of Wires: By this application the kindersigneclAiyes.podcieof his or her inteition to p,scform the electrical work described below. Location(Street&Number) 1) 64 e t\CO0 .. 11,- . • Owner.or Tenant D u t p O r r tc. Telephone No. CO' -- 44q Owner's Address --CA-fn.J!�' Is this permit in conjunction with a bui dingpermit? Yes 0 No (Check Appropriate Box) Purpose of Building D W�� \ f \13 Utility Authorization No. _ Existing Service Amps / Volts Overhead ❑ Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity • ,Location and Nature of Proposed Electrical Work: ( j t (� g..eADLerce:Ame,n, P•-II'�lc., (v�., �1I N c-ee �! r t � Completion of the following table may be waived by the;r:spec tor 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.oti Lmergency Lighting grnd urttd. Battery Units No.of Receptacle Outlets No,of Oil Burners FIRE ALARMS No.of Zones No.of Switches (No.of Gas Burners No. Initiatof ing Devices Teta No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • _T No.of Waste Disposers Heat Pump Number.. ons,__KW_ No,of Self-Contained Totals: — Detection/Alerting_Devices No.of Dishwashers Space/Area Heating KW' _Local Q C nnechaln 1-1 ?r No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water ters KW No.of No.of Data Wiring: eSigns Ballasts No.of Devices or Equivalent No. H;dromassage Bathtubs No.of Motors Total HP Telecommunications tWiriug: No.of Devices or Equivalent OTHER: - Attach additional detail if desired;or as required by the Inspector of Wires. Estimated Value of 1ec ' al Work: (When required by municipal policy.) Work to Start: l t ) 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: INSURANCE li< BOND 0 OTHER X(Specify:) (Jo cKes Coyvp I certify, under t'----=--- ---'-----"-- WAYNE SCHMIDT y,that the information onthis icati n is true and complete. �� FIRM NAME:- ELECTRICIAN LIC.NO.: _ Licensee 222 WILLIMANTIC DRIVE r MARSTONS MILLS, MA 02648— Stgnatu LIC.NO.: (If applicable,ente (508)428-7747 ne.) Bus.Tel.No.• i'(�Q ��j�17i Address: Alt.Tel.No.: �l/(� ]/ / J *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. Nzt — 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)0 owner ❑owner's a ent. Owner/Agent� ��. Signature Telephone No. • ( PERMIT FEE: $ 1