BLDE-21-006928 r `0 � Commonwealth of BLDE-21-006928 Permit No. Official Use Only
€ L Massachusetts
'' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.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:5/30/2021
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. / Gy
Location(Street&Number) 38 TOURAINE WAY t4( 9 _ �(P B
Owner or Tenant DUBOIS JULIAN M TRS Telephone No.
Owner's Address DUBOIS FAMILY TRUST, 38 TOURAINE WAY,SOUTH YARMOUTH, MA 02664
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters
New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Replacement panel.
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/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 ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME:
Licensee: Rodrigo DeAssuncao Signature LIC.NO.: 56081
(1f applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:36 Linden Avenue, North Andover MA 01845-4315 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
t\f/A_ W:e(ot LE--
P N-Ma 0-5-/v
Commonwealth of flamachasette Official Use Only` / G� �j
,'1/414..._0' yt Apartment o�.t' S' Permit No. 2i —(J/ �1S
arse Services
N Occupancy and Fee Checked
,,- 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( EC), 27 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL L ORMATION) Date: 05 c2t/
City or Town of: 8,y milli'h To the Inspector of Wires:
By this application the undersign "ves notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 36 1®(a�,- 1 ej 00All
Owner or Tenant DU gob S U�;i AN ni! IRS Telephone No.
Owner's Address 3 8 ''O()RAI NE, 11iA 4
Is this permit in conjunction with a building per t? Yes 0 No ® (Check Appropriate Box)
Purpose of Building £E,S/ AirI P(, Utility Authorization No.
Existing Service ICJ) Amps /do / 1 O Volts Overhead 0 Undgrd 12 No.of Meters I
New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity a,J li Cb A
Location and Nature of Proposed Electrical Work: G I e_r. E L 190N.11.1
P i"/ $v\k
I� I
IX 0� ; Completion of the following table may be waived by the Inspector of Wires,
f No.of Recessed Luminaires No.of Cell.-Soap.(Paddle)Fans No.of Total
`-,�' - Transformers KVA
- I No.of Luminaire Outlets No.of Hot Tubs Generators KVA
a No.of Luminaires Above In- 'No.of Emer en Li
Swimming Pool nd. ❑ grad. ❑ Battery Unitsg
R ry11
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
r Total
Initiating Devices
-,� ........._., No.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
Connection 0 other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of Devices or Equivalent
Heaters KW No.of 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 if desired,or as required by the Inspector of Wires.
Estimated Value of ec ' al Work: 0 (When required by municipal policy.)
Work to Start: 5 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE CO RAGE: 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 ® 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: 12Ctet KO ( 17J xAssunicAo LIC.NO.: 56 0,91-l3
Licensee:► l66 PACh&Co 4e A .U/{1Gfifo Signature 1 LIC.NO.:-
5 -0,'-Ir E
(If applicable,,enter "Tempt"in the li en c nu line.)
Address: 66 Li noia Ave. �t h gl,C,r 44,/� Qi wt i J Bus.Tel.No.• � '53 ! .
requiresAlt.Tel.No.:
'Per M.G.L.c. 147,s.57-61,securit
y work 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
Signature Telephone No. 1 PERMIT FEE:$