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Home My WebLink AboutBLDE-22-005223 or Commonwealth of Official Use Only fE Massachusetts Permit No. BLDE-22-005223 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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 perform the electrical work described below. Location(Street&Number) 1341 ROUTE 28 Owner or Tenant PANAGIOTU MATTHEW W TR Telephone No. Owner's Address ZOITSA PANAGIOTOU TRUST, 25 TERRACE DR,WORCESTER, MA 01609-1415 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: Miscellaneous work per attached. (CAPE COD LOCK&SAFE) 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. Ton l 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 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 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 al-WA,rc. 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 F -L- • Commonweaeth o/ttla.maahudetto Official Use Only C 'MI- 1) �Uepartment entre Services Permit No. _Z�' ��j r' ..„,, BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked '� [Rev,1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the assachusetts Electrical Cod (MEC,pi79v1R 12.00 (PLEASE PRINT IN INK L qR ,.,'4 Date: -) �l� City or Town of:�u 0 To the Inspector of Wires: By this application the undersign Ives notice of his+for her ntent tggorform the electrical work described below Location(Street&Number) J " I 1�r Owner UrTenant`a f u l ,;�K fi S 0 ! Address ' Telephone•-- '__ .- Owner's Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building �`\L, (Check Appropriate Box) Utility Authorization No. Existing Service Amps • / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd[] No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Sl. Y1S; q S 1� �_t . i :�ll lic for ,US�)t J • IYz etc c. —_-- Completion of thefollowing table may be waived by the Inspector ofWire 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.of Emergency Lightinggrnd. groat', Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No,of Gas Burners No.of Ditection and Initiating Devices Totallo.of Ranges No.of Air Cond. Tonsi No.of Alerting Devices No.• of Waste Disposers Heat Pump Number•.,[Tons KW No,of Self-Contained Totals:( •.. •.•........•.••.....I.•...._...••.••.....• (Detection/Alerting Devices ,— No.of Dishwashers Space/Area Heating KW ,Local❑Mal Connectunicipion ❑Other No.of Dryers Heating Appliances Idly 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 . .,saga at;teubs No.of tviotors fotai He\ No,of DevicesJor. Equivalent i OTHER: u,,g t Si l4 ��Z, 4't I -1 •kt l Atiach additional detail icipal p li as required by the Inspector of Wires. v Estimated Value,pf lectrical Work; (When required by municipal policy.) �\ Work to Start: 1 57 Inspections to be requested in accordance with MEC Rule 10,and upon completion, INSURANCE CO ERAGE: 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 DI (Specify:) ' I certify,us "" --- •- ^ '---net the Information on this application is true and complete,FIRM NAI WAYNE ELECTRICIAN SCHMIDT n 411 LIC,NO.: ?�"�, au Licensee: 222 WILLIMANTIC DRIVE o ,DaC 1 Licensee:-, MARSTONS MILLS,MA 02648 Signature s LIC.NO.: (If• Address: (508)428-7747 Bus, TTel.No. 061/ 1 "Per M.G,L.c,147,s.57-61,security work requires Department of Public Safety"S"License: Alt Lic,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. lam the(check one owner ❑owner's agent Owner/Agent Signature Telephone No, PERMIT • • h ) t� j 1 •