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Home My WebLink AboutBLDE-22-004381 ,;; ommonwealth of Official Use Only # • �-, Permit No. BLDE-22-004381 ' 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) pate•2/8/2022 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) 239 BLUE ROCK RD Owner or Tenant Jim Gleason Telephone No. Owner's Address 239 BLUE ROCK RD, SOUTH YARMOUTH, MA 02664-2223 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 ❑ 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: Miscellaneous work per attached. 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. Total No.of Alerting Devices ns 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 ❑ M n eunis palln 0 Other: Cct No.of Dryers Heating Appliances KW Security Systems:* y No.of Devices or Equivalent No.of Water No.of No.of Ballasts Data Wiring: Heaters KW tSinns No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: y g No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. required bymunicipal policy.) Estimated Value of Electrical Work: (Whenq p p y' 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 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. 'PERMIT FEE: $75.00 I t� *e/ ef•foe 26112 Ft r.7-45- Ck4.41.3-5.--) Commonwealth oll Massachusetts O Dial Use Only el, � Permit No. CZ 3e r C y Zepartmsnt of gire&pukes Z BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fen Checked [Rev, 1/07] APPLICATION. FOR PERMIT TO PE�tPOR1111A� °��t°3blankw� �A' All work to be performed in accordance with the assachusetts Electrical CEIrECTRICA 1.02.. WORK (PLEASE PRINT ININC O L s D Date: City or Town of: By this application the undersi ' e o ee To the Inspe for of tress Location(Street&N�„nber) or her ten n to P electrical work described below. Owner'or Tenant Lihn Owner's Address Telephone No. 30 7 Is this permit in conju on with a utldin g permit? Yes - Purpose of Building -- � � -- - - -- N0 El _._._(Check Appropriate Box) Utility Authorization No. Existing Service Amps •• / Volts Overhead ❑. Undgrd 0 No.of Meters _...� vitkeice Amps / Volts Overhead[] Undgrd 0 No.of Meters Number of Feeders and Ampacity • Lees on and Nature of Proposed Electrical Work: , fir Com letion o the allow*: table m be waived b the t ector o Wires; No.of Recessed Luminaires No.of Ceil.-Soap.(Paddle)Fanso.o No.of Luminaire Outlets � • Transformers KVANo.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above (] In- No.or E mergency Lighting rnd. nd: Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARIVIS No.of Zones No.of Switches No.of Gas Burners No.o'Setection and • No.of Ranges Initiating Devices Total No.of Air Cond. Tons ,No.of Alerting Devices No.of Waste Disposers Heat Pump lY ubgl Tong - CW No.of Self-Contained Totals:I "'"' �' """"'"""' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0.Municipal No.of DryersAppliances C Tin:el 0 ��' t'Y Heating Appliances ,y Willie. s ems; No.of Water__ - - --_ No.of -- No.of evices or Equivalent Heaters KWNo.-of Wiring: Signs Ballasts - - — No.Hydromassage Bathtubs No.of Devices or Equivalent • g No.of Motors Total HPTelecommunications Wiring; OTHER: (N 1.J A ?.._e_e_03 1 ,9 No.of Devices or Equivalent Estimated Yalu o Ete al ark; yyy Attach additional detail if desired,or as required by the Inspector of Wires. • Work tot Stark (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO E GE: 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: INS_URANCF BOND CIO•HER _�._� I eerie,us _ 0 (Specify:) FIRM NAI WAYNE SCH MI DT 'rat the information on this application is true and complete ELECTRICIAN LIC.NO.: Licensee: 222 WILLIMANTIC DRIVE arappltcabb MARSTONS MILLS, MA 02648 Signature ^ / - LIC.NO.; • Address; (508)428.7747 Bus.Tel.No.. •r. np . *Per M.G.L.c, 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel. c.No.• 1�_ OBI�I 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 .III owner I Owner/Agent Owner's a:ent. Signature Telephone No. PERMIT FEB:$ rig