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Home My WebLink AboutBLDE-22-005243 Y Commonwealth of Official Use Only f . 1 Massachusetts Permit No. BLDE-22-005243 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:3/21/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perf e electrical workrnrib�ed^be�low. Location(Street&Number) 69 ROUTE 28S Owner or Tenant MESHWA CORPORATION r Telephone No. Owner's Address 69 ROUTE 28,WEST YARMOUTH, MA 02673 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: Repairs to room#114 as needed. 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 Initia<tine Devices No.of Ranges No.of Air Cond. Total No.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 Signs No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: $260.00 �1 z2�2v Com› EiTcor oh-on-0A 64-14-r/g A40•z i i z i Qd3s'-i3 • Commonwealth of asdachuds d Official Use Only qt ni y �epartmant o f Serviced Permit No. 22 S^?,�-�'� Occupancy and Fee Checked 'v.,, -" 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 assachusetts Eleotrioald (PLEASE PRINT IN INK O' t ;` L I / Date: 1(M I--�— �.,s 7C 2.00 City or Town of: 0.di To the Inspector of Wires; By this application the undersign:: _ yes no.ce h's or her ti to perfo a electrical.work described below Location(Street&Number) Ct ' is rn + 1 �. . Owner'or Tenant IA Ar\ 1. L �t Owner's Address �` hone No. �— � s Is this permit in conjunctionwiwith a building permit? Yes No Purpose of Building ,0 1 c_� ❑ (Check Appropriate Box) , Utility Authorization No. Existing Service - - ._.._-Amps - / Volts- Overhead❑ Und rd Meters Service g No.of Meters Amps / Volts Overhead 0 Undgr,0 No.of Meters Number of Feeders and Ampacity � 1 0 1 4 � Location and Nature of Proposed Electrical Work: s" ' Conviction of theJollowing table may be waived 6y the Voter ol'Wirer No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Transformers No.of Al KV No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires _Swimming Pool Above ❑ In- 0 No.or Lmergency Lighting 'n�. Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones • No.ofSwitches No.of Gas Burners No.of Detecifon and • No.of Ranges Total Initiating Devices Na.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers• 'ea 'ump .,u ;,gf....;ons•.,.•, ,�,`+....., ' 'o.o e °- on a ne Totals: Detection/Alerting Devices No,of Dishwashers Space/Area Heating KW Local❑.Municipal Cannectton 0 °t1 1�' No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or E•ulvalent • No.Hydromassage Bathtubs No.of Motors Total HP a ecommun ca ons `f r ng: OTHER:s tj4%c I No.of Devices or Equivalent • � Attach additional detail desired or �� E$timated Value f Ela trical Work; lT as required by the Inspector of Wires. Work to Startl Electrical � (When required by municipal policy.) 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 eo erage is in force,and has exhibited proof of same to the permit issuing office, CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:)I certify,ur -_ ..__. -- 4.. ., FIRM NAI WAYNE SCH M I DT - "' the Information on this application is true and comp ELECTRICIAN 1 I LICE NO.: l_.__._.11 Licensee: MARSTONS MILLS IMAR02648 (IfapplicablSignature, -4L�r LIC.NO.: • Address: (508)428.7747 Bus.Tel.No.. •414r►M � . *Per M.G.Lc. 147,s.57-61,security work requires Department of Public Safety S License: LiAlt.Tel. ..No..No, , �i 7� OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By mysignature below,I hereby waive this requirement I am the(check one . owner Ili owner's a.ent, Owner/Agent Signature Telephone No. p• PERMIT FEE:$ . . • - Feb 04 2000 1022AM HP FaxWayne 5084287747 page 1 3 I 23)g— WAYNE- CUMIDT ::Mass'-,L[l�, E33699 I<508)400747 222 Drive,Marstons Mills, MA 02648 D S Ifk& V4T` — 69 w ts-x--2_yvvrcAke VII& I I 9. Re...Pka.A Y .‘tt E..)(t -1--‘4( kln N?rsQr (A)cdNe-c- 0:\-Y\k-cl4at— cohck. raiv\k tAvrm s Thscsyny,&„2,&._ ct_v„), t us a \m' ry N E Sc h F 3)z3} Z