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Home My WebLink AboutBLDE-23-002522 Commonwealth of Official Use Only >✓ K Massachusetts Permit No. BLDE-23-002522 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:11/8/2022 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) 266 ROUTE 6A Owner or Tenant YARMOUTH NEW CHURCH PRESRVTN FNDN INC Telephone No. Owner's Address 50 QUINCY ST, CAMBRIDGE, MA 02138-3013 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: Install underground trench and wire for street sign light. 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 Tons 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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of 1 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 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $80.00 fee3a C4103C g3/ • Commonweal o /�j� / -== �//la��ac'hu�atts • Official Use Only __ _ S1.3-zi7 - Ifr�=^ epartmeni a/gi s' Permit No. # era aruicea e . [R BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Yl4--. [Rev. 1/07] leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the assachusetts Electrical C de C) 527 CMR 12,00 (PLEASE PRINT ININ.K O L Date: G— CPR or Town of: '� By this application the undersign ; To the Inspector of Wires: g notice of his or her ntention to perform the electrical work d cribed below. Location(Street&Number) 'lV -•-4 ,el- Owner'or Tenant i r , C} c �r�• �lt,►' g vl V►'% Telephone No. _j� — Jr Owner's Address • / _ ,;• _ f La.,. Is this permit in conjun tion with a b iildfn permit? yes ❑ No , Purpose of Buildinga��!' ,'/'!'ti►' " ,l'� �• (Check Appropriate Box) m, yet �1�� VA et.I nu ed'Utility Authorization No. Existing Service Amps / Volts Overhead __ _ ❑ Undgrd❑ No.of Meters _ New Service Amps; ,.. ps 1 ."�Vous Overhead LJ Undgrd Li No,of Meters Number of Feeders and Ampacity — • Location and Nature of Proposed Electrical Work: Ki A LI ry,.--co fie'AA co (.)k Lt...'i,rt. i v C 1,1/4.: Com !Mono the oilmen table ma be waived by the Ins ector of Wires. No.of Recessed Luminaires No,of Ceil,-Susp.(Paddle)Fans °•° Tota No.of Lutninafre Outlets Transformers KVA No.of Hot Tubs Generators KVA No,of Luminaires Swimming Pool Above ❑ In- -No.oI ii mergency Lighting • grad, grad', ❑ 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 No,of Ranges Initiating Devices No.of Air Cond. Total Tons .No. of Alerting Devices No,of Waste Disposers Heat ump Ytmber oas o, o e ontained Totals: ,,,,,,,,,,,,,, ,,,,.,,,,,,,,,,,.,,,,,•,,,,,,,•,,.,„,,,, Detection/Alerting Devices No,of Dishwashers • Space/Area Heating KW' Local Municipal No,of Dryers �' Connection ❑ Other Heating Appliances KW eCtrrty ste ITST No.of Water KWNo.of No,of evices or lEpuivalent Heaters No, ofData lX'►rrn Si ns Ballasts No.of Devices or E No.Hydromassage Bathtubs No,of Motors Total HP uivalent • Telecommunications IvIng, viiiC,tc: " _� ivo.of i)evices or Equivalent Estimated Value of Flee real Work. Attachrequired additional detail if desired, or as required by the Inspector of Wires. Work to Start; / ,� (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 co erage is in force,and has exhibited proof of same to the permit issuing office, CHECK ONE: INSURANCE BOND ❑ OTHER I certify,ui _......_ _....,_..... ._ _ ..� 0 (Specify:) FIRM NAI WAYNE SCHMIDT ''at the information on this application is true and completes.,ELECTRICIAN rl, '' uy I Licensee: 222 WILLIMANTIC DRIVE LIC.NO•: ,tiF (If Licensee: • - MARSTONS MILLS, MA 02648 Signature • (508)428.7747 LIC. NO,: Address; Bus.Tel.No,: �y. *Per M,G,L,c, 147, s,57-61,security work requires Department of public Safety"S"License: Lic,No. I /d OWNER'S INSURANCE WAIVE Alt.Tel.No.;* '� R: 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/Agent_ Signature 0 own- '- •:eat, Telephone No. PEI2MiT FEE:$ `�