EP-065 ANW 6..-8-7—c-0--4-&
Report '. \r/ron 777� Fee pd $ 70.00
Owner Robert Gauvin �tJ\Jii L�.� J _L . Date 8/6/92
Address 3 COUNTRY ACRE RD. , N. D. 84/18-5 Permit No. 65
Contractor George Lebeau E17630 99 2 9292 / llo (jRed
Address 5 Willow St. , Acushnet, MA 02743
Remarks NEW DWELLING: 200 amps. , 220 volts, 1 me4q43itq*i3krr .undergr.
1 range, 1 dishwasher, 1 dryer, i1 water heat.
1 oil burner A,
Will call . ` rj
k V.
Insp cted By: Date
VCR,'
SZ— Otttce Use Oran
The Cornmornw- -of Massachusetts
�.; � ►erect Xs. 6J
Department of Public Safety ^� _��
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Occaicy e Q,ectad
14 r BOARD OF FIRE PAEYENT10N REGULATIONS 527 CMR S2:OO �/90lam G G
t.
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL VVORK
All work to be ptriormed In accordance with the-Maeeachuseru Electrical Code, S27 CMR 12:00 a
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date n..
City or Town of pf}Iir,yoze TI ' To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below
Location (Street bc `h:^ber)- -3 COU.4/7kt y %C h'6 R ] //( -5J
Owner or Tenant (Ra$E'?T ( 4 u 1/id/
Owner's Address .,3 Ca r.(y7R)/ Al ei F' b• .
Is this permit in conjunction with a building permit: Yes 0 No ❑ (Check Appropriate Box)
•
Purpose of Building G� ,t Utility Authorization NO. _
Existing Service Asps / Volts Overhead ❑ Undgrd❑ No. of Meters
-- Few"Se is .- - - Alto--fps- ilia /2� Fates - Overhead ❑ •Undgrd No. of Meters /
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work V//7E- NSW - U sE -
No. of Lighting Outlets No. of Hot Iubs No. of Transformers Tot
No. of Lighting Fixtures Above In-
grnd..❑ grnd. ❑
Swimming Pool Generators .RVA
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
No. of Ranges /
No. of Air Cond. Total No. of Detection and
tons Initiating Devices
-No of of Disposals No. of pimps Total
Total . No. of Sounding Devices
No. of Dishwashers / Space/Area Heating ICJ No. of Self Contained
! Detection/Sounding Devices
No. of Dryers / Heating Devices KW Local❑ Hanicipal ❑Other
Connection.
No. of Water Heaters / KW Simsf a Ballasts W rin¢ltage -
No. Hydro Massage Tubs No. of Motors Total HP •
O'IfiER:
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 Q6 NO DI I have submitted valid proof of same to this office. YES® NO
If you have checked YES, please indicate the type of coverage by checking the appropriate box. .
INSURANCE 5i1 BOND ❑ OTHER ❑ `,� '(Please Specify) i4 trAzir
Estimated Value of Electrical Work S ( xpiration�DatF�
Work to Start . Inspection Date Requested: Rough w �f.� Final � t,iCX4
Signed under the penalties of perjury:
FIRM NAME • LIC. NO.
• Licensee George Lebeau Signature gyp.i/ ei-Q�..e,� LIC. NO. E]7630
Address 5 Willow St. Acushnet, Na, 02743 Bus. Tel. No. .
-Air. Tel. No. -99Z- Z9Z
-OWNER'S INSURANCE WAIVER: ' Z as 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 FEES 74'�`
(Sig-nature of Owner or Age^t)
3
RECEIPT FOR PERMIT
e� ouTx.y'\d TOWN OF DARTMOUTH ‘ . j
QFjp p PERMIT NO.
\ _ _ No
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o 787.
Date (LI6. /!C
Y0Z.
R''eceived From. „
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OAner
Location . /2 -
Type C-C.C(%1--e—,
Amount Paid 7C/ ''
' a_ ` 9/6
Received By Yd` `Vs
RECEIPT FOR PERMIT
�� ouTx•Mr. TOWN OF DARTMOUTH 4
oe��r PERMIT NO.
s = : f ,
30 4— I
No
r. Date ( i Q ,....0 6/ / / c- . 1
Received From ,.r.- t;:-..4. , F=�^ ... - 7 '- "--t,t...>
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OWfier ( ,./-,-
Location r. qa...r__.t_4,\., .:N-..-f (1 ,,,,� , -_
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Type , f t..,..._4..e_.
Amount Pale It,' - . I,
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Received By , -'.. .-.,.z1,-. .; `--f."`