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Home My WebLink AboutBLDE-19-003516 Commonwealth of Official Use Only Permit No. BLDE-19-003516 Massachusetts 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•12/11/2018 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�j f electrical work �'2 describedn bel Location(Street&Number) 32 KATHARYN MICHAEL RD U . i ��Ls( f G 41 - Owner or Tenant Telephone No. Owner's Address THIRTY TWO KATHRYN MICHAEL RD TRUST, 3566 ELM ST, CALABASAS,CA 91302 Is this permit in conjunction with a building permit? Yes ❑ 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: Additional 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 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 ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of 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 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: WALTER W KELLY Licensee: Walter W Kelly Signature LIC.NO.: 21302 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:7 MONROE LN,WEST YARMOUTH MA 026732731 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 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 ,4- i1i 6i , 1\ ' Vv 1r � �1 Ca g4 /� �nsn:onmsa al/r/a�ae�zCedsEfj Official Use Only - ' i c� Permit No. �' ., _ 2epartment o' Serviced 1 --- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071, (leave blank) 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 INFORMATIQ Date: / /id t o City or Town of: YAR1VIOUTH To the I e�tor Wires_ �P By this application the►indersigned gives notice of his or her intend to perform the electrical work described below. Location(Street&Number) et. ct t A. Owner.or Tenant PC,/ (. i t Telephone No? 3 7 0 76 9. Owner's Address t Is this permit in conjunction with a building permit? Yes ❑ No 2- (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead D Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity O t iLocation and Nature of Proposed Electrical Work: i- I&� µ�g7'er/6 t UA N It-) ,�jx�J/le- U G•isVIZ ,�s /l SMQ// i rn tittttit 9� CrU t-S i - Qpletc-ggiantT OSp-t r�S iLs q' .5-eQ t 7yT GLe L ir • Completion tithe foIlawing.table may be waived by the Inspector of Wires. "� No.of Recessed Luminaires No.of Ce1-Soap.(Paddle)Fans No.of To ja1 Transformers KVA 0. No.of Luminaire Outlets No.of Hot Tubs Generators KVA _ %..J - No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Irmergency Lighting `� grnd _mid- Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones t No.of Switches No.of Gas Burners No.of Detection and y 0/ ..• Initiating Devices -..-J No.of Ranges No.of Air Cond. Tom No.of Alerting Devices (J.) No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: ,Detection/Alerting_Devices No.of Dishwashers Space/Area Heating KW' .LocalQ Municipal Systems:* �10r No.of Dryers Heating Appliances KW ��f yster or Equivalent No.of Water 3 s ICVV No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent - No.Hydromassage Bathtubs OTHER No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent td Attach additional detail Y.desired or as required by the Inspector of Wires. Estimated Value of Electrical Work (When required by municipal policy.) Work to Start: 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 coverage is in force,and has exhibited proof of same to the permit issuing office. 0. CHECK ONE: INSURANCE. BOND 0 OTHER 0 (Specify:) I certzfy,under pains and penalties ofpeTltulry,that the m jrmationn on this application is true and complete. FIRM NAME: H 4--er () t lc•;Q.l t=-1 [" TIC 1 (4&) JIl1C LIC.NO.: N30019- Licensee: C 4--el" IC Qt gnature (�'o Q Yc1.�P LIC.NO.:c1 jai/e 1 (If applicable,enter"exempt"in the lice rnanber!ru.) Bus.TeL No.; . Address.-7 1.0A){l(,re L /0 „ 1' R sT y4 rM 0i.J , 1f/ Alt.Tel.No.:,,VO,2/n 7 4'1 7d j *Per M.G. c. 14 ,s.57-61,security work requires Department of Public Safety"S"License: 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)0 owner ❑owner's agent ` Owner/Agent I Signature Telephone No. PERMIT FEE: $ Contract Walter W Kelly Electrician, Inc Master License#21302-A PO Box 663 South Yarmouth,MA 02664 508-360-6471 www.walterwkellyelectrician.com DATE 12/4/2018 NAME/ADDRESS CONTRACT NO. 1695 Barbara Breidenbach 32 Katharyn Michael JOB Yarmouthport,MA 02675 QTY DESCRIPTION This is a price for the installation of the following electrical apparatus at the job location.(see job above) Replace master bath vanity light fixture Wire and install small bath vanity light and switch Replace existing front exterior plug Replace front oswl and add light block 4 Licensed Master Electrician 1 15A weather/tamper resistant GFI 2 1-gang deep ow pl box 1 PVC LIGHT BLOCK RECTANGLE 1/2"LAP ARLINGTON 1 15a-120v 1-pole switch 1 1-gang nylon plt 1 3.5'metal pc box 25 wire 14-2 rx per ft 6 1/2"-2" jiffy screw 6 wirenut yellow,orange,OR SMALL BLUE+GRAY 1 Permit Fee Thank you for your business. TOTAL TERMS OF PAYMENT: Due on receipt SIGNATURE