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Home My WebLink AboutBLDE-22-003665 or Commonwealth of Official Use Only Oh....;537- - Massachusetts Permit No. BLDE-22-003665 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:12/30/2021 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 ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. �N�7�Existing Service Amps Volts Overhead 0 Undgrd 0 �✓ ✓f eters New Service Amps Volts Overhead 0 Undgrd 0 No. kike ers Number of Feeders and Ampacity q)::).'`V Location and Nature of Proposed Electrical Work: Wire furnace. a Completion of the following table may 'v y ector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No,of O al Transformers A No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lit o grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of o No.of Switches No.of Gas Burners 1 No.of Detection and Initiatine 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 6No.of No.of Ballasts Data Wiring: Heaters Siens 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 '€e- SC) = y/l/yl// --` t-omrnoraa,al f rrtaddac�ttd Official Use Only ie- :-tea • `liii � `/ii-_ ParG�nf al girt:Services Permit No. �Z2-34 4 S 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 Massachusetts Electrical Cgr�(1 ,Ck,5z21 .i 7 nn (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: II 7l�II/�] 7�]�Jlj City or Town of: YAR\'IOUTH To the Inspector of Wires: u vp{ By this application the pndersigned 'yes no'ce of his or her intenciin t perfo the electrical work described b6Iob%. Location(Street&Number) `J Owner or Tenant Q' �( Telephone No. Owner's Address —rain.L Is this permit in conjunction with a building permit? Yes ❑ No (Check f t.\ �� tAppropriate Box) W Purpose of Building D \ Utility Authorization No. Existing Service Amps / Volts Overhead❑ Und rd g ❑ Na.of Meters New Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters Number of Feeders and Ampacity -- Lo tion and Nature of Proposed Electrical Work: (j1 (�o NLpre_e_rvie,ATT-'kS urN■,t_� 11 s 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 0 ernd. Hrttd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners~ No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. To No.of Alerting Devices • Tons Heat Pump Number Tons KW No.of Self-Contained Totals:I �--"� Detection/Alerting Devi No.of Waste Disposers ces No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ❑Other No.of Dryers Heating Appliances KW Security Systems:" No.of Water No.of Devices or Equivalent No.of No.of KW Data Wiring: Heaters Signs Ballasts 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 l/e�tr o Work: (When required by municipal policy.) ` Work to Start: L� f�� Li 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. CHECK ONE: INSURANCE X BOND ❑ OTHER (Specify:) (,,o IKerS(r N M I certf under t`--- --- fn on `''�s �f WAYNE SCHMIDT Y.that the information this icati n s true and complete, FIRM NAME: ELECTRICIAN � f9i�S�69 222 0NS MILLS, DRIVE ,� LIC.NO.:_Y�"' l l Licensee: ARSTONS MILLS,MA 02648_Signatu (If applicable,ente Tel. NO.: �]J Address: (508)428-7747 ne.) Bus.Tel.No.:�ZS=i<--LL�`' // ,j .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. I am the(check one ❑owner ❑owner's a ent u Owner/Agent , Signature Telephone No. ' PERMIT FEE:$ - _ _ - 4