E-19-1593 �a
Commonwealth of
Jfr OfftcialUse Only
etw,�g Massachusetts Permit No. BLDE-19-001593
' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
f Rev.l/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:9/17/2018
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his oilier intention to perform the eiecGcarwork described below.
Location(Street&Number) 8 GINGER PLUM LN
Owner or Tenant FERRIS RICHARD A Telephone No.
Owner's Address 1032 KOKOMO KEY LN, DELRAY BEACH,FL 33483
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 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: Replacement HVAC.
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- 1:1No.of Emergency Lighting
grnd. grnd. Batten,Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners 1 No.of Detection and
InitiatlncDevices
No.of Ranges No.of Air Cond. 1 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 ❑ 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 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: Charles G Munroe
Licensee: Charles G Munroe Signature LIC.NO.: 18520
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:19 E COMMERCIAL ST,WELLFLEET MA 026677451 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
be 9 9116(ig
f
JQ-C.--- 114
_ animomota of tt/ateachaiie Official Use On
L_ .+, .1JtParinrtnt of.girt J Petmit No.
vices
`a Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07]
(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 INFORMATION) Date: ,47/,,,,
City or Town of: YAR1VIOUTH 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) e(-;,./d7 0tl2, p3' t/no / n) • Sc) yt.I/,., a
Owner or Tenant Pt,6.4f--€.-- Rent t Telephone No.
&2
Owner's Address
Is this permit in conjunction with a building permit? Yes 0 No i�
`6J� �1 (Check Appropriate Box)
Purpose of Building Utility Authorization No.
ztsttng Service /or) Amps Jy,,,,/�7(�W5 Volts Overhead Er Und d
r gr ❑ No.of Meters
�. tu ew Service _ Amps /
Ill ® Volts Overhead 0 Undgrd 0 No,of Meters
mbar of Feeders and Ampacity
+> o a ' tion and Nature of,Proposed Electrical Wort ger 0W� /,��n7 ) ,Jia)a e,e
•
„ O Completion of the following table maybe waived by the Inspector of Wirer,
V' W Z of Recessed LuminairesNo.of
Lu t : to o No.of CeiL-Susp.(Paddle)Fans Total
Transformers KVA _
N .of Luminaire Outlets No.of Hot Tubs Generators KVA
('. c.
-
• td.of Luminaires Swimming Pool Above Q In- No.of Emergency Lighting
grnd. In-d. 0 Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS f No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
• Initiating Devices
No.of Ranges No.of Air Cond. I Ton Z No.of Alerting Devices
•
No.of Waste Disposers Heat Pump I Number}Tons I KW No.of Self-Contained
Totals: Detection/Aiertingpevices
No.of Dishwashers Space/Area HeatingKW' Municipal —
fowl❑ Connction Q ""rr
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of No.of Devices or Equivalent
Heaters No.of Data Wiring
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 rf desired or ar required by the Inspector of Wires.
Estimated Value of Electrical World (When required by municipal policy.)
Work to Start: 9//4/4' R. Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE CO ERA 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 cova is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:)
I tenth,ander the pains and penalties ofperjury,that the information on this application is true and complete
FIRM NAME:
Licensee: f�/���� I, LIC.NO.:
(If applicable,enterf "memos" `sc mnnber ie.. signature�fi� � e. LIC.
No.'IS��t'��` d
empt"in the license.number line) Bus.Tel.No..
Address. .. .o,.e, ,• G F ..._, er Alt Tel.No.:.Y14 fC a —/'?D(
J Per M.G.L.c. 147,s.57.61,security work requires Department of Pu.lic Safety"S"License: Lic.No.
< OWNER'S INSUBy my signature RANCE WAIVERbelowI: I amhhaware that the Licensee does not have the liability insurance coverage normally
red , hereby waive this requirement. I am the(check one)0 owner ❑owner's agent
Owner/Agentrequibylaw.
I Signature Telephone No. ( PERMIT FEE: $ �j b