The URL can be used to link to this page

Home My WebLink AboutBLDE-23-004499 or Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-004499 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:2/14/2023 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) 24 DEACON ST Owner or Tenant DUFFY DIANNE M Telephone No. Owner's Address 24 DEACON ST,SOUTH YARMOUTH, MA 02664-2915 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: Mitsubishi NC system 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 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 Tn Total No.of Alerting Devices 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 ❑ Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* ry No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: y l; 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 ❑ (Specify:) I certify,under the pains and penalties of perjuty,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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMI I T FEE: $50.00 ek c 3((413 14 T - • 4% Commonweal of t<ilasaacha eNd • '1� ,i Official Use Only Permit No. Z3—I4n 2ePartment o �lre Serviced y,:., ;;,,.> BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev, 1/o77 leave blank APPLICATION..FOR PERMIT TO p All work to be performed in accordance with the ass ELECTRICAL WORK (PLEASE PRINT IN INK 0• r ),s27 FM ,a r City or Town of: Date: � _� By this application the undersign i �� '� To the es not ce of his or her ntention toperfo. Inspector of Tres: Location(Street&Number) the electrical work described below. Owner'or Tenant � �- '' -LI ' . Owner's Adc(ren , A .' �71 `la, V Telephone N, *��'�� Is this permit in conk: n w th . Purpose of it Building ildln permit. Yes I�•-t u No ❑ (Check Appropriate Box) .Existing Service`� Amps • / L Utility Authorization No. olts Overhead [� Undgrd[� No.of Meters o Servic ._ Amps / Number of Feeders and Ampaci��'��'Volts Overhead 0 Undgrd 0 No,of Meters Locatio a d Nature of)'ropos d Bloc cal oink: �!'�""' __.d.....,, A ..• A lei No.of Recessed Luminaires• Com•lesion o the ollowtn_ table ma be waived by the Ins•ector 6 Wires. No.of Ceii,-Soap.(Paddle)Fans • -o.o No.of Lumtnairo Outlets Transformers KVA No.of Hot Tubs Generators KVA • No.of Luminaires Swimming Pool ; 'ove g `at o Uni encg No.of Receptacle Outlets :rnd. 0 !gut. ❑ Batter Units y 'g i n No.of Oil Burners FIRE ALARMS No.of Zones No.ofSwitches No.of Gas Burners 'co.o I e ect on an• No.of Ranges o a Initiatin Devices No,of Air Cond. No.of Alerting Devices No.of Waste Disposers Wai_ "Tons `eat 'ump - one , f, 1 •o e--•-. • Na,of Dishwashers • Totals: ,.,°, onta ne Detection/Alertin_ Devices"Space/Area Heating KW' Local 0 o n ecti No.of Dryers HeatingAppliances r Connection ❑ Other o.o -,a er pP KW ec•.tr;ty S s ems: Heaters KW ,o•o No.of Devices or E.uivalent O.o Data Wiring: No.Hydro massage a Bathtubs Sins Ballasts No.of Devices or E.civalent • No.of Motors Total HP elecommun cations wing: OTHER: No.of Devices or E.uiva7ent • Estimated Val f Attach additional detail¢1desired,or as required by the Inspector of Wires. Work to S • (When required by municipal policy.) Work to NC CO speotions to be requested in accordance with MEC Rule 10,and upon completion. E: .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 e undersigned certifies that such oo rage is in force,and has exhibited proof of same to the permit' CHECK ONE: INSURANCEequivalent, The BOND 0 OTHER (Specify:) issuing office, FIRM NAI WAYNE$CH M I DT net the lnformaden on this application is true and complete. ELECTRICIAN Licensee: 222 WILLIMANTICLLS, DRIVE I;IC,NO.: ,_ (Ifapplicabl� MARSTONS MILLS, MA 02648 Signature """ • Address: (S08)428.7747 LIC.NO.: Bus.Tel,No.: ., ."" '*Per M.O.L.c, 147,s.57-6I,security work requires Department of Public Safe "S" ' � '7 2171 Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance required by law. By my signature below,I hereby waive this requirement. I am the(check Lic,No, Owner/Agent coverage normally Signature ( heck one .[J owner [J owner' ent, Telephone No. PLq'Rll??7'F' x'• : ~