HomeMy WebLinkAboutBLDE-23-002133 { Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-23-002133
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
(Rev.1/071
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:10/20/2022
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) 9 DOVES WING RD 1,`�"/�fylD' 910 —
Owner or Tenant FIJOL JOHN J Telephone No.
Owner's Address FIJOL SHERYL J,19 WADSWORTH RD,SHREWSBURY,MA 01545
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: Permit to close out expired permit#E21-6299.
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
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 ❑ Municipal 0 Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water Kµ, No.of No.of Ballasts Data Wiring:
Heaters Slims 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:
Licensee: Signature LIC.NO.:
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 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) ❑owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$50.00
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RECEivEb R-ectcf9
T
OCT 2 0 2022 , ;
BUILDING p t.`'r j Commonwealth.of///aadachasetia Official Use Only�
By - --- " ` 23— Lil',,'.�5, .. c� c Permit No.
:�1,1^ Occupancy and Fee Checked
. s BOARD OF FIRE PREVENTION REGULATIONS [Rev. 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: /l C/i c/). 1-
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned ives notice of his or her intention to perform the electrical work described below.
Location(Street&Number)C1 /I 1,'yt a(
Owner or Tenant CiC-h,'] r' e(f 1) t /)l Telephone No.
Owner's Address !"( Lc)iXd�l.J �7/fit /‹._A. ~ !ce4h) v/� ()A d , 1Zj 1----
Is this permit in conjunction with a building permit? Yes i% No n (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Set-vice 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: J,vnt) ,,. /,7-e� is/t-h - ,j)z/ J 0f )\
v Completion of the followinkiable may be waived by the Ins ector of Wires.
Lit No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans No.or [trial
Transformers KVA
�1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA
t No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
�i No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
It. Initiating Devices
Totallo.of Ranges No.of Air Cond. Tons
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❑ Municipal ❑ OtherConnection
No.of Dryers Heating Appliances KW Security Systems:
No.of Water No.of Devices or Equivalent
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: 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.
CHECK ONE: INSURANCE 0 BOND ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:
Licensee: Signature LIC.NO.:
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:
Alt.Tel.No.:
*Per M.G.L.c. 147,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. y my signature b ow,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent.
Owner/Agent` `�
Signature Telephone No,S .j4T I PERMIT FEE: $ SD— l
j
C((-4 3b 2
,� � TOWN OF YARMOUTH Building Department BUILDING
• Y (508) 398-2231 ext.1261
k.ti...or
Oci PERMIT NO rBLD-21-003162 4PERMIT
ISSUE DATE 12/11/2020
A JOB WEATHER CARD
4' ,ini. « .;.: :. . ,:; R PE 'OEM 4 1,ww.c<,.,att.,<14,«.,.<.. a.»«.,x<:.m«<N,<«m«,x..I.»m,.tg :< mm
APPLICANT :FIJOL JOHN J PERMIT TO ' Alteration :
neN .».,<..x.K.W. 1 M,I i f.,.a f.w A.«o n,r b.«V ft.»f,.»ft.M,..,f.«..w X„C.w w„t,».P k:16.w,,.w Ma w,.,»,ft..'
AT (LOCATION) 9 DOVES WING RD, YARMOUTH, MA 02675 ZONING DISTRICT R-40 Bldg. Type: Residential
SUBDIVISION MAP BLOCK LOT a109.5.17 BUILDING IS TO BE: CONST TYPE V B USE GROUP R-3
::...m'%km:<..MNM.axM<N a+>.Pa»e�:'.•^mte»HC.b'trtv<i
.....,,., .:....�. ,M._.._.r.... ..m.,...__. __... ....... ....:. . ... .... ...._... _.:,.........,a__. v:. _x .,.... _._.:w. _. ._.._._..�. w..w,.,.,._.._......-....__..... CONTRACTOR
..,�.
REMARKS Alterations per approved plan 780 CMR MSBC, 9th Edition - Add bath to CO 1
upstairs master bedroom (508-904-3049) LICENSE ll
'Mmn''..m.'r.:......:mvm,,....:.m+.... .a......w, ,; ......... ............. ..m...-. ...;. (REA (SQ FT) 853,863,120. EST COST($) 20000.00 PERMIT FEE $) 150.00
v
OWNERFIJOL JOHN J BUILDING DER BY
ADDRESS 1FIJOL SHERYL J, 19 WADSWORTH RD �/
._____
SHREWSBURY MA 01545 1 .,4.r` �'' PHONEr_______________T
HIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILI
.R PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE
PPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE
'BTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. 'THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM
HE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM INSPECTIONS REQUIRED FOR ALL APPROVED PLANS MUST BE RETAINED ON WHERE APPLICABLE
',ONSTRUCTION WORK: 1) FOUNDATIONS OR JOB AND THIS CARD KEPT POSTED UNTIL SEPARATE PERMITS ARE
:OOTINGS. 2) PRIOR TO COVERING STRUCTURAL FINAL INSPECTION HAS BEEN MADE. REQUIRED FOR ELECTRICAL
MEMBERS (READY FOR LATH OR FINISH WHERE A CERTIFICATE OF OCCUPANCY IS PLUMBING/GAS AND
COVERING) 3) FINAL INSPECTION BEFORE REQUIRED, SUCH BUILDING SHALL NOT BE MECHANICAL INSTALLATIONS.
OCCUPIED UNTIL FINAL INSPECTION HAS
OCCUPANCY 4) REFER TO DETAILED INSPECTION BEEN MADE.
SCHEDULE
POST THIS CARD SO IT IS VISIBLE FROM STREET
,UILDING INSPECTIONS APPROVALS
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OTHER:
JORK SHALL NOT PROCEED PERMIT WILL BECOME NULL AND VOID IF INPSECTIONS INDICATED ON THIS CARD
INTIL THE INSPECTOR HAS CONSTRUCTION WORK IS NOT STARTED WITHIN CAN BE ARRANGED FOR BY TELEPHONE
,PPROVED THE VARIOUS SIX MONTHS OF DATE THE PERMIT IS ISSUED AS OR WRITTEN NOTIFICATION.
TAGES OF CONSTRUCTION NOTED ABOVE.