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Home My WebLink AboutBLDE-23-004500 9rr � /.1 � Commonwealth of Official Use Only � Permit No. BLDE-23-004500 �-•• Massachusetts 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) 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 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 (Expired permit) 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 lnitiatine 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 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 Sins 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 5(z*Z0 tIL4 6c2) (In_ '' -1= a l�' Official Use Only s__�1�.- cy' �f `nl .CJ partment of y S' Permit Nol 73'y- -1D— Yr Pratal! BOARD OF FIRE PREVENTION REGULATIONS Occupancy•and Fee Checked jRev.I/07] (leave blank) APPLICATION FORIPERMIT TO PERFORM ELECTRICAL WORK All work to be perfonned in accordance with the Massachusetts Electtir"t•,.+-^ ^ T a (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date City or Town of: YAR1VIOUTH To the Inspector of Wires: By this application the pndersignet yes no-ce of his or her intentn t perfo the electrical work describe�1b i,(' Location(Street&Number) [ "�'a`" .�s.��it�g�� Owner or Tenant � ✓� LJ Telephone No. -- Owner's Address -.c • L Is this permit in conjunction with a bu'ding permit? Yes ❑ No Check A Purpose of BuildingD �.�,� ( Appropriate Box) \ r t3 Utility Authorization No, Existing Service Amps / Volts Overhead E. Undgrd❑ No.of Meters _ New Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Loudon and Nature of Proposed Electrical Work: r Com lesion of the ollowin table if be waived b the fns etctor o Wires. No.of Recessed Luminaires No.of Ceil,susp-(Paddle)Fans o•of Total No.of Luminaire OutletsTransformers KVA No.nfHotTubs Generators KVA No,of Luminaires Swimming pool Above In- No.of 14mergency Lighting gmd, arltd, ❑ Battery Units No.of Receptacle Outlets No,of Oil Burners -� FIRB ALARMS No.of Zones No,of Switches No.of Gas Burner- No.of Detection and No.of Ranges Initiating Devices No.of Air Coed, o Tons No,of Alerting Devices No.of Waste Dis osers eat imp umber Tons p Totals - o,of elf- ontaine No of Dishwashers ' lertn Dry Space/Area Heating KW' Local0 Municrpal No,of Dryers Connection 0 Other rY Heating Appliances KW Security Systems:" No.of ales KV, No o No,of Devices or E uivalent Heaters . o 0 Data Wiring: Signs Ballasts No.of Devices or Ecui to No.Hydromassage Bathtubs va.,,r. No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E.uivalent Estimated Value of le�rri Work; Attach additional detail if desired or as required by the Inspector of Wires. Est Stal • (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO ERAG : 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. ICHECK ONE: INSURANCE BOND ❑ OTHER (Specify:) (( ��Oc�, er Cen13 certi under t'----,--_-.--'-----'-'---r-...._ WV l t i n t an 1 FIRM NAME: WAYNE SCHMIDT y'that the information on this icati n is true and complete ?? qa ELECTRICIAN Licensee:--MARSTONS IMILLS,IMA R0264 SIna8_ g to LW.NO.: LIC.NO,: (If applicable,eats (508)428-7747 ne.) Address: Bus.Tel.No: -- J Safety License: Lie.No. Per M.G.L.c,147,s-57-61,security work requires Department of Public Safe S" lt-Tel,No.��1/J .;,-•x- OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n — 5 required by law. By my signature below,i hereby waive this requirement- lam the(check one 0 owner CI owner's a ens u Owner/Agent i • Sighature � Telephone No.---____� PERMIT FEE:$