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Home My WebLink AboutBLDE-22-005515 #5 Commonwealth of Official Use Only ti Massachusetts Permit No. BLDE-22-005515 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:3/31/2022 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) 845 ROUTE 28 Owner or Tenant JANFRA RLTY LLC Telephone No. Owner's Address 87 TONELA LN, BARNSTABLE, MA 02630 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 HVAC(Roof top unit) 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. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners E ALARMS No.of Zones No.of Switches No.of Gas Burner 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1Ton 1 No.of Alerting Devices No.of Waste Disposers Heat Pump Number ns KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area He ing 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 Siens No.of Devices or Eauivalent 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: $80.00 G S Cusromec. US(AIG pt;� Use � 4f �4l7 FetfLd— WI. 1.1- - . Commoaweaih of addaeftaiegd Official Use Only `! c� Permit No. (7-/ __V-2--"-Sr - i2-- (S NI' . 2apartment of 5lre�erviced • BOARD OF FIRE PREVENTION REGULATIONS [ROccupancy and Fee Checked ev.1/07] (leave blank) APPLICATION. FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the assachusetts Electrical Cod ,5,27 CMR 12.00 (PLEASE PRINT ININK O• / r .0 Date: 3 11 1 City or Town of: V11 rTo the Inspector of Wires: By this application the undersign ;ves no,ce of his or h-) ntention to perform thcelectrical ork described bel. .. Location(Street& ,ber) „ ( • 6 !y a !� :i11�_. Owner'or Tenant til, t -diet Telephone No. . - ,C la Owner's Address ' • __Is this permit in conjunction:with,'building permit? Yes 0 No ,1�1� ¶') (Check Appropriate Box) Purpose of Building '-t' Utilitythorization No. Existing Service Amps • / Volts Overhead ❑. Undgrd❑ No.of Meters New Service Amps / yolts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity • Loc on and Nature of Proposed Ele cal Worts: Ai �1ii`att r Completion of thefollowln table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell,-Soap.(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.or Emergency Lighting grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zon~_ No.of Switches No.of Gas Burners hyo.of Detection and- Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump I Num er-(Tones_w BCW - No.of Self-Contained Totals:I"'u r Detection/Alerting Devices No,of Dishwashers Space/Area Heating KW Local 0 Monnectiounicipaln 0 Other C 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 Equivalent • No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of/ Devicesror uival1I'- i nt OTHER: A . . i & i 1 V t1 I % W 1 I I (Lc � if Pipe_ Attach additional detat ' esired,or as required by the Inspector of Wires. T • Estimated Value oflectrical Worki (When required by municipal policy.) Work to Start: a • 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 co 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'ui '-- ' "--'•-- • '-• "' .•-••~'tat the information on this application is true and compl WAYNE SCHMIDT FIRM NAI ELECTRICIAN LIC.NO.: Licensee: 222 WILLIMANTIC DRIVE Signature a- LIC.NO.: (Ifapplicabl� MARSTONS MILLS, MA 02648 . • Address: (508)428-7747 Bus.Tel.No.: 17' . *Per M.G.L.c, 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lie.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).❑owner ❑owner's ent. Owner/Agent I Signature Telephone No. I PERMIT FEE:$