HomeMy WebLinkAbout0035 SHERYLES WAY _ � _ _
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The Town of Barnstable
p1F Permit# //9 Z 7
Massachusetts ///�7/gam
BA�MU& ; Date
NAM SOLID FUEL STOVE PERMIT
1659. .� D
MR Fee � ,
This constitutes an official stove permit after inspection and approval by the building inspector.
elephone no.
Address of Property 5 Village /Ir_
Location and Stove Type
i
Date:
uilding Inspector
The solid fuel burning stove at the above location passed: failed: inspection.
«�-1"1Fw'D..•j44-' ifi2.` riY?:.:i;f {'.o,>: �' s� '�`.; �a.�"'c �' - 1-r.Y�4f� J'yia"g• "t -:�iw"€. isJ;:�,.'q. .,i^5� iLe' •w�4, - $ate='•»�_•
'rdWN OF BARNSTABLE MASS CHUSETT � �..�� - ILD NG PERMIT
A®045 044- � -`��'= -•��- ' '" September 13 94 �Q �7024
DATE 1 PERr�IT NO.
APPLICANT Nick Lagadinos ADDRESS i u, n•, C:Otuit
INO.) (STREET) (CONTR•S LICENSE)
PERMIT TO guild dwelling 2) STORY Single family dwelling NUMDWEBERNG UNITS 1
(TYPE OF PROVEMENT) NO. (PROPOSED USE)
lot #3 : 35 Sheers Way, Marstons Mills ZONING RF 1
AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
¢ LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION G"
(TYPE)
Sewage #94-450
REMARKS: "
BOND
AREA OR 1968 s • f t•
VOLUME Q ESTIMATED COST � 150,000 FEE
17,7.25
(CUBIC/SQUARE FEET)
OWNER
Joan & Domenick Ravita
�
BUILDING D
ADDRESS BY
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EI_jj1ER TEMPORARILY OR
PERMANENTLY. ENCROACHMENTS 6N PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP-
PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED
FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL 'APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND
I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MEMBERS(READY TO LATH).3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE.
OCCUPANCY.
POST THIS CARD SO IT IS' VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS ' • PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
IF
140
2 2 � 2
HEATING INSPE ON APPRO ALS ENGINEERING DEPARTMENT
y 1
BOA OF HEALTH
OTHER SITE PLA REVIEW PROVAL / a_ ��•
Or � a
CO
WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE
TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN
CONSTRUCTION. PERMIT 1S ISSUED AS NOTED ABOVE. NOTIFICATION.
- Dn-= d
BUII.bIYI(f"`PF3:LT NO. 37o 2-
3
ASSESSORS PARCEL NO.
r CONTINUATION OF ROAD BOND
The unce_si�e owne_/coutractOr he=eov =22 t.7 IIa1:.i �n t::e�� road band im
fo:c: cnti?vthe follovi:Ig work ite�s a=_ ccW�le*a, to tue sat- ion of G.e
�s�ac�
E:E,ne-_i:.s 'Sec::-:on of the 'Deoar=ent of Public- c:o ks:
lca"— and sae3 slaculde=s as. soon as
waEcae=
-
i '
Y.J\+C1i�0 1•
ZLL, 766L �/I/
(G;rr;L./C .;ir._C�:ct) — (pr;zc --name
__... .. . ............. .
.r.ala :::.17c__ i
dptt�
: . . : The Town of Barnstable
1"9. ��' Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
*-n . to
TOWN OF BARNSTABLE �
Permit No. ......:.........
BUILDING DEPARTMENT
I ""'T I TOWN OFFICE BUILDING Cash
.610.. x
HYANNIS,MASS.02601 Bond
CERTIFICATE OF USE AND OCCUPANCY
Issued to Joan and Domenick Ravita
Address 35 Sheryls Way (Lot #3),
Marstons Mills, MA
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
December 30 94
. ....... . ..... .. ... . . ... 19................. ....... . ...............
Building Inspector
I
'7''��� � � � c�` �( �'7c ''�'`'��c
a r CQMMO�`�1� C7 �� �.Y�I�.JJI]C VJ�.Lr:J S
ELF JEl'E1` ENT OF 1?-iD UST
ItiAL�CCIDEN7�
1� a:k`
..G00 WASHIT�'GTON ST�REI'
fames Camoaei BOSTON, MASSACHUSETTS 02111
�c-�:ss�one•
WORKERS' COMPENSATION INSURANCE AFFIDAVIT
(licensee/permincc)
,A,ith a principal place of business/residcncc at: '
�1�07tJi
(City/State/Zip)
do hereby certify, under the pains and penalties of perjury; that:
142m an employer providing the following workers' compcnsation coverage for my employees working on this
Job-
lnsurancc Company Policy Numbcr
[J 1 am a sole proprietor and havc no one working for me.
J 1 am as olc proprietor, general conuaaor or homeowner (eirdc one) and havc hired the contractors listed belowwho have the following workers'compcnsation insurance politics:
• I .
- 1
Name of Contmaor Insurance Company/Policy Number
name of Contractor lnsurancc Company/Policy Number
Namc of Contractor lnsurancc Company/Policy Number
0 1 am a homeowner performing all the work myself
NOTE Plcasc 6c aware tbat while borncowacrs who employ persons to do maiateaaaec,eoostruaioo or repair worlc on a
d—»ding of not more tba.a three uniu is wbicb the homeowner also resides or on the grouods appuruoaat thereto arc not gcoerally i
considered to be eruploycts under the Worl`crs'Cornpcnsatioa Act(GL C. 152.sect. 1(5)),application by a bomcowaer for a liecasc
or permit may cvidcocc the legal sutus of:s;cr_ploycr under the Workcrs'Compcasation Act.
i unocrstanc tnat a copy of tius statement-IC oc forM•asdcd to&,c Dcpa:t.cnt of lndustriaJ Acadcnu'C)Mcc of 1nse nce for.covcrx;C
vtriftution and that failure to secure eovcngc as required under Section 25A of MGL 152 can lead to the imposition of..uminaJ penalties
consisong of a fine of up to S1500.00 and/or imprisonment of up'to one year and civil penalucs in the form of a Stop"Work Order and a
fine of S100.00 a day against me. C'
Si cd this day ll , 19 6
Lice nscc/Pcrmi cc Licensor/Pcrmiaor
G`•,+t�7�AS� 7t �, ' ."s•,,�f"� r 7 f�•� � .• e�7i�83r?_a::�,•L w-.i�„`i�,.
ebi . , � i' a' 4 DEPARTMENT OF PUBLIC SAFETY
Y � , ' ONE ASHBORTON PLACE + MEL
f�a, e a y'x t, r I `'•BOSTON,MA 02108•�°°"""'""_`�....
Li iie ,�te stotl 0 a L I C E N S E * '�/, rr `
" use only' befot "ex iratiod�dates If found'; '' aN S T R-:7 S U P E R V I S 0 R
ret to:One As urton Place'Run• 301 EFFEC
0 ! TIVE DATE #' LIC-NO
06/30/1993 a�
t i )y Y �J> �<,� � � •�,a . ' is 0126S3
N HOLAS A DIN
COTU08 .1
IT-.MAO LAND
�2 6 3 S
• -NOT VALID UNTIL• NED B LICENSEE AND OFFICIALLY '
QTAMPED- TU E OF THE -
COMMISS1ONER
.: :y. I'•,,.., +� LICENSEE
rn
' is
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suasrn'I ,sqw �� x
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dt� rat �L T J ` ALE
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Scale Y16=1' z
ca
o
- �
Ridge Vent V] O 3
x8
q TQ?S
Architect Shingles
/ \�• 10/12 pitch
VS 606 ,
Pitch 12/12 ,O
C235 w/CTC2 over
i�
White Cedar Shingles S"TW '
is
C24 w\CTC2 Over C14 a C14 V
IH
BriaStva
Front Elevation
&1
Scale Y16 1' qq
O D
S 308 VS 309
U.
11 I1
11 11
White cedar Mm%la ►�
�• w6w,
P4
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Rear Elevation
&1
scde 3n6-r z
Cn
White Ceder
screen ran
U
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Ww�NIM
6i
Left Elevation .
Fit
Scale Y16-1' z
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A
A a
U�
♦ /
Wbit!ceaaz shy W
f
♦ / Seem Porch
U
N
t��k►1 i a
�sR Elevation
B.1
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` flame Dd� A 24
T Mae" � •�
nxeo•
cW1s cwu � A �
2rxsolm mxwlm cu a
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GARAGE
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1 6 '14 Im Q�
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to
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R
SHOW
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as a
4
PLO
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A-1
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A
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y
F
9,-� U
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h
14' 6' T
aNaAaR
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II 6'3 —+—11'2 6'S 1 •^O.
F 24' 1�
ST 1
rug uw
A-1
c-
Scale 3/16—1'
n
- 2x10 ridge 235#Fberglass shingles A .�
15#felt paper t1
_.. _ 1/2"CDX roof Sheathing Q 0
235#Fiberglass shingles
IS#felt paper US rafters rn
1/2'CDX roof Sheathing O x
' - 2x6 cer7ing joistslx8 collar lies F1
10 � - - 9
2x10 front
12 U a
2350 Fiberglass shingles 12
15#felt paper
1/2'CDX roof Sheathing
2x10 Rafters
2x6 ceiling joists
O
2x10 floor'oists 112"CDX 1/2"drywall ceiling 2x10 floor joists
3 Plywood R-30 ceding insulation 3/4"T and G subfloor
112"CDX Plywood W10rt26 Steel Beam 3/4"T and G subfloor \2x4IGD.Stud Glued and Screw Nailed
2x4 Studs Glued end Screw Nailed 31/2"R-11 fiberglass insulation
W Fvecode Sheetrock R-19 Hatt insulation sal
1\2" all
31\2"R-11 Insulation
314'T and G subfloor
Glued and Screw Nailed
2x10 KD.floor joists �a
v" 8-x 4'poured concrete foundation 25000 R-19 Fiberglass insulation
err 4'poured concrete floor 30W# 2x6 P.T.Plate \3-2x10 beam
L 1/4'sill seal 31t2'Talley cohiam -O
8'x T6"poured concrete wall 2500# F
8'x 16"keyed poured concrete footing 2500# 30"Xi05d0"footing 2500#
4"poured concrete floor 3000#
Section A-A
f anu�.w
Section B-B
E-1
78.
/2
r
..�� GARAGE
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N
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NOTES:
ITHIS PLAN IS VALID ONLY IF IT IS STAMPED AND
SIGNED IN RED. THIS OFFICE ASSUMES NO
RESPONSIBILITY FOR INFORMATION CONTAINED ON
COPIES WHICH DO NOT HAVE ORIGINAL STAMPS
AND SIGNATURES. IN RED IIAS- BUILT II PLOT PLAN
2 THIS PLAN STANDARDS S ET FORTH IN NOT RE250E CMRT SECTION 6.04 O THE �'1La.►�ST�7�-� I t L MASS.
THEREFORE THIS PLAN IS NOT TO BE USED' FOR • - •'v'^SS•
TITLE INSURANCE- PURPOSES Lot
1 CERTIFY TO 60r4 .
AND. TO T'-I� -rowN �F r���+��-���>v R. J. O NEARN, " SURVEYOR
THAT TO THE BEST OF MY INFORMATION , SWAN RIVER PLAZA , 35 ROUTE 134 UNIT 3
.KNOWLEDGE , AND BELIEF , THE I SOUTH DENNIS, MA. 0266b
oar-I pAl-)of ! SHOWN ON THIS PLAN
JOB NO.
HAS BEEN LOCATED ON THE GROUND AS �N OF
INDICATED AND THAT IT IS LOCATED IN ? '�ti DATE
FLOOD ZONE C PER FLOOD INSURANCE _� RICF'faRD -�Iq-
RATE MAP DATED CLIENT
O'hff__.i- "'fy LAG�G1i.lOS
roc:2', SCALE
ByJ IJ 6
AT EG. PROF S O A LAND SURVEYOR SHEET I OFF_
Assessor's office(1st Floor):,
Assessors map and lot num r - �-- . SEPTIC �� TEM MUST BE
Conservation(4th Floor
Board of Health(3rd fl WITH TITTLE 5 •
DA81�T�DL
Sewage Permit number ENVIROMPYIENTAL CODE M �.,.
Engineering Department(3rd floor): ' - s TGUM ['EGULAMONG °° i630
House number '� a �p
Definitive Plan Approved by Planning Board
APPLICATIONS PROCESSED 8:30-9:30 A.Mf and 1:00-2:00 P.M.onl Y'`
I '/�'�;r
TOWN . OF BARN,STABLE
r SUILDING : 11SPECT0R
APPLICATION FOR PERMIT TO m6rw 2�I L/
TYPE OF CONSTRUCTION
IV
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location LOT _ -5d& t/ V Al?/}1 67V A S IVIZI
Proposed Usef��sl7fs71//° ',7
Zoning District Fire District C
Name of Owner��>M� IC� U )J TJ Address /�n� <`J(',�QT_ S%� �'(�7V�
Name of Builder Irk L&wD//(MY Address � C'aJRJf.
c �
Name of Architect Address
Number of Rooms /0 Foundation sPay� KI(id/I�.�f7c
ExteriorlLlW���(At/ 55YZ"�-16S Roofing Zr"�S � `A)m S(2 jil2C/ -M7 5X 970's
Floors '�( 1F7e (e?/140-1 77i1n2 erior D"jyd
Heating / �2 �1 t i I7S Plumbing ( (/L�s
Fireplace Approximate Cost C , 6 E
fig
Gt/UUc( f�s— Area , s
Diagram of Lot and Building with Dimensions Fee
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Bar s able regar ' g t e a ve construction.
Nam
Construction Siipervisor's License
. RAVITA, JOAN & DOMENICK.
35 SHERYLS WAY, MARSTONS MILLS
«. r1 D V
tNo 3- 9-t4 Permit For 2 story
S. F. D.
Location
Owner
Type of Construction -!
Plot Lot
Permit Grarited Sept. 13 , 19 94 "
Date of Inspection:
Frame
Insulation
Fireplacei
�a a Date Completed 19 -
E a
1
Z a
4 i
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type)
TOWN OF BARNSTABLE Date -3 19 `�
Building 3s Permit#
AT: Location __ _ T X S " Owner's
Name (/t// hi 1•
Type of Occupancy:
New Renovation ❑ Replacement ❑
Plans
FIXTURES Submitted: Yes❑ No �Y
Z In <
Z Y
F• N J N O Z. =
W aL J it; > t,i ya z 0 C tC
0 W f W tC = tC so W Z Z Z G F
J N N N
or
Z tC O ¢ ill La > < H N = O < N = Q 4 Q 0 W
tC W 0 W < 0 S < W Us Q J a tL O J
LiW = < S ; 3 0 2 S aL IL O ~cc
< >< < W IL ac W
H V > �, O Z 6 � to ►'• Z O• O N Z _Z W � O t) Z
Z < ~ < < S N < < O < J J < tC Q 0 < O < 1"
Y J O y D O J ; Z H eD tt 0 O < ; C O 0
t
sus—BSMT.
BASEMENT
•
0 1ST FLOOR
2
0
2NOFLOOR
3RDFLOOR
4TH FLOOR
0
r STH FLOOR
BTH FLOOR
7THFLOOR
STH FLOOR
(Print or Type) Q '/
Installing Company Name y�% /���1� Check one: Certificate
I 41 /
Address J� /' (� ���/ ❑ Corp.
1
�n � 6�� ❑ Partnership
'�lv irm/Company
• Business Telephone Y7 7" 6736y 9 Name of Licensed Plumber
/Limed
I hereby certify that all of Ure details and informalton 1 bare wbmilled for entered)In shove application are uue and accunle to Iltt best of my
kno-ledge and that all plumbing work and installations perlonsrcd under permit issued for Utis application will be in compliance with all pertinent plo•
visions of the Massachusetts State Numbing Code and Chapter I42 of tla CCUCIVl Laws
I have informed the owner or his agent that I do not have liability
insurance including completed operations coverage.
Signature of Owner Agent
I have a current lia insurance policy to include completed operations
coverage.
By
Title _ si nature of Licensed Plumber
Ty e f Plumbing License
City/Town: � 7 �j/, -
APPROVED (OFFICE USE ONLY)
License Number ❑ Master ourneyman
BELOW FOR OFFICE USE ONLY
PROGRESS INSPECTIONS
FINAL INSPECTIONS. SKETCHf-$
J' cep FEE
APPLICATION FOR PERMIT TO DO PLUMBING _ f
NAME 1 TYPE OF BUILDING
LOCATION OF BUILDING '
PLUMBER
z ,
PERMIT GRANTED
DATE 19
PLUMBING INSPECTOR
Y MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(print or Type)
TOWN OF BARNSTABLE Date ZZ 19 9y
Hyannis, Massachusetts permit I ' r-1�0I g
Building * IPS— Ovner's d
AT: Location �0 I S � � �"�
yhi Name / Ttf
t4lS T-,rl-tis /&1/GL.S _ Type of Occupancy: '�Ix/6a ��VY
Renovation [] Replacement
GPlans Submitted Yes ❑ No 0 '
w
w � w
w w a s c d
W W i o u r
s
s a
0 �, R
• M t W F w t t W
w O i O >
ey
W W w to Z O s c me � i oci ►' � F- _ „ a
O 1- Z J �' ►- !- } e6 e i 0 Z 1J O q
i = O O =' t � ; O � J N It ! � � F O
•us-ssMT.
BASEMENT
1ST FLOOR
!NO FLOOR
SRO FLOOR
ITN FLOOR
aTN FLOON
aTN FLOOR
?TN FLOOR
aTN FLOOII
(Print or Type)
� ����� �� �h k One: Certificate
Installing Company Name �'�`
l 7 fi�yll'y �Corp.
Address y 0 partnership
y
Cofllpany
Business Telephone 4/7 7-090 9 Name of Licensed Plumber or Gasfitter
1 heroby arrtify that aU of the dateW and Information I Mr submitted(or entered)In above application ore Im and ocearote to then►aM of am
knowtedse and that all OlombinS work and bata/atbns performed ander hrmlt (awed for thle a"Umdon ail be In onsapWms with as/WMMI
pro.Ylone of the Wsadtrrtts State Gaa CtiM asul C7aptor Ida of the C."Wai)aim
1 have Informed the owner or his agent that I .do not have liability
Insurance including completed operations coverage.
Signature of Owner/Agent
I have a current Sabi)) rance policy to Include completed operations
coverage.
By TYEZ LICENSE: /2z
Replumber L
Title Gasfitter S gnatyre of Licensed
City/Town: Master Plumber or/Gasfitter
urneyman
APPROVED (OFFICE USE ONLv)
License Number
f'
BELOW FOR OFFICE USE ONLY
FINAL INSPECTION SKETCHES PROGRESS INSPECTION
2-1 l _ FEE
l - NO. �Sµq
APPLICATION FOR PERMIT TO DO GASFITTING
• P
f
i
NAME i TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER OR GASFITTER
LIC. NO.
PERMIT GRANTED
DATE 199,
GAS INSPECTOR
...�x_ "�`Y r.^'.�..i -tir^b.� -. . _..�i -.�r....:+r�,-.v...-r5:..-�.y��,...-...n„�!'sr.�"�t.r'-.:fr .o.'.c.,�.e•-.-;r _. . . .-_ -. .,.,tea,... -- .•
.A
APPLICATION FOR PERMIT TO INSTALL AND REQUEST
L FOR ELECTRICAL SERVICE I 1 �+'l��
Inspector of Wired Wiring Permit# COM/El-e_trricc##�.
Town of Massachusetts Building Permit# Date
Customer: ( on(Street#) 3•s.,�s
Lot# 3 in the village of y pole nu�un erground number 83S
Customer's billing address r
Temporary New installation ` Change of service Starting Date9, �y
Job description
Service entrance voltage �'�Q Amperage �sU Phase
Wire size(cu.or al.)
Alf Conductor per phase
Number of meters Water heater—1V Off peak:Yes— No ✓
Estimated load:Electric heat�kw, li hts_ kw, Range X dryer S Motors, H.P.& Phase �`J`'��
y - Ready for first inspection �D y Ready for final inspection Of
Electrical Contractor Lic.# Telephone# ��5y
Address G 2,65-3 Z
Additional Remarks:
Do Not Write Below This Line
ELECTRICAL WIRING INSPECTION CERTIFICATE
INSPECTOR OF WIRES
INSPECTIONS DATE FEE CHARGE
Temporary Service -
✓Roughing in �eWOLMUZv/go "O
Service and Meter ��
Off Peak'Meter
Final Approval
Disapproved'
'For the following reasons
CERTIFICATE OF INSPECTION DATE
To the COMMONWEALTH ELECTRIC COMPANY.The installation described above has been completed and has this en inspected and
approval granted for connection to your service. 0
Ins ctor of Wires
WIRING INSPECTOR TO BE NOTIFIED WHEN WORK IS READY FOR INSPECTION
t Permit Good For One Year From Date Of Issue CA as-,
White—COM/Electric Green—Inspector Canary—Town Receipt Pink—Inspector's Copy Goldenrod—Electrical Contractor
to COM/Electric.
tr
Office Use Only
The Commonwealth of Massachusetts Permit No.
De;arrment of Public Safety Occupancy&Fee Chocked
BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 12:CO 1 3/90 (Icaveblaa)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All Work to be performed in accordance with the Massachusetts Electrical Code. 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date +
TOWN OF BARNSTABLE To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street b Number)
Other or Tenant
Owner's Address
Is this permit in conjunction with a building permit: Yes No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization NO.
Existing Service Amps x/ Volts Overhead ❑ Undgrd ❑ No. of Meters
New Service f3 7 Amps p / Volts Overhead 20,"Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total
KVA
No. of Lighting Fixtures Above❑ rn ❑
8 B Swimming Pool grnd. grnd. Generators KVA
No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting
Battery Units
No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones
Total No. of Detection and
No. of Ranges No. of Air Cond. tons Initiating Devices
Heat
No. of Disposals No. of Pumps
Total Total No. of Sounding Devices
Tons KW g
No. of Dishwashers Space/Area Heating KW No. of Self Contained
Detection/Sounding Devices
No. of Dryers Heating Devices KW Local❑ Municipal Connection❑Other
No. of
No. of Water Heaters KW No. f Signs Ballasts WirLow ng
Voltage
No. Hydro Massage Tubs No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial
equivalent. YES( NO[J I have submitted valid proof of same to this office. YES WI- NO
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
/ q
INSURANCE rZKOND ❑ OTHER ❑ (Please Specify)
(Expiration Date7
Estimated Value of Electrical Work S
Work to Start Inspection Date Requested: Rough r inal
Signed under the penalties of perjury:
FIRM NAME_ LIC.-NO__._/4( ,
Licensee Signature LIC. NO.
Address Bus. 641. No.
Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub-
stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit
application waives this requirement. Owner Agent (Please check one)
Telephone No. PERMIT FEE S 0
Signature of Owner or Agent