EP-672 12/09/94 paid re-inspection fee $ 30 . 00
Report ' - �(e pd $ 80.00
Owner Robert G. Raposo ciig ZO ..0 LEt . 5/17/94
Address 5 BLUEBERRY LANE, N. D. 66/2-30 Permit No. 672
Contractor same as above 67 8 3(392. Yellow Red
Blue
Address PO Box 301 , Fall River, MA 02724 Green 1-
Remarks NEW DWELLING: 200 amps. , 220 volts , 1 meter undergrd.
6 out, 15 fix, 30 rec, 15 sw. ,1 range, 1 dish-
CM,1115`J'f f er, 1 dryer, 2 oil burners. Est. value:
Will_ call .
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Inspected By: Date
RECEIPT FOR PERMIT
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WNR_Wk_InFD WORK KEOUE5T INFORMATION ` PtGt 1 OF 1
JUL 14 , 1394
Work Request No : 73378 Entry Date : 12-JUL-94 Roo . Date : 25-JUL-94
Entered By : LEGEK ^ G[OK8ETTE L . Rate /Rev Code :
WR Type : NEW SERVICE Annual Base Rev :
WR Status : SCH[0 Annual KWH:
W& Description : UG/RE5 NEW HOME
WR #amw/Customr : RAPD5O` J0SEPH S
Service Address : 5 BLUEBERRY LH &oct# : - -
City : DARTM0UTH
'
Pnle/Pad/MH No : 10147 /0308 Lot : 15 Plot :
Designer : PKZYDYSZEN8KI , CYNTHIA
CONTACTS Name Typo Phone No
FALL KlYEK^ MA 02724 BUILD ( ) - x
PO VOX 301 BUILD ( ) - x
KAPO5O , J03 [PH 6 BUILD ( 308 ) 995-2084 x
ELECTRICAL
REQUIREMENTS Service Voltage : 120 /240 3W 1PH Number of Meters : 1
Amperage : 200 Type of Heat ;
Phase : l Meter Number :
Service Location : LOC OK--TLM 93566
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__ Office Use Only i
The Commonwealth of Massachusetts Permit No. v / -'
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_'`�_ Department ofPublic Safety (leave blaukj .. -/7-5
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BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
Town of Dartmouth
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 () 4t1,(� /7 J R9 41
The undersigned applies for a permit to performpeil the electricali work described below. J / '/ /
Location (Street&Number) 17 R C U 1 ,6-k'R y A_/7`v�_ rF) '�J — 3 `'
Owner or Tenant E�,fJSG'f�N �9-, JC/1
O 542 /
Owner's Address ra (eq x ' i U4 YC?VFk; 0 ,4 or ^ 11
Is this permit in conjunction with a building permit: ' Yes 1 4 No ❑ (Check Appropriate Box)
l?Purpose of Building - C.tz t'-itcl/\- Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd [1 No. of Meters
New Service _-t_C7 Amps //C / 0 Volts Overhead ❑ Undgrd Y,� No. of Meters /
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No. of Lighting Outlets 6 No. of Hot Tubs .0 No. of Transformers Total
KVA
No. of Lighting Fixtures /5 Swimming Pool �dve ❑ grnd ❑ Generators KVA
No. of Receptacle Outlets 3 0 No. of Oil Burners & No. of Emergency Lighting
Battery Units
No. of Switch Outlets /5 No. of Gas Burners FIRE ALARMS NO. of Zones
No. of Ranges Total No. of Detection and
g / No. of Air Cond. Tons Initiating Devices
No. of Disposals No. of Heat Total Total of Sounding No.
Pumps Tons KW Devices
No. of Dishwashers Space/Area Heating KW No. of Self Contained
Detection/Sounding Devices
No. of Dryers HeatingDevices KW ❑ Municipal ❑
rY / Local Connection Other
No. of No. of Low Voltage
No. of Water Heaters KW
yAve Signs Ballasts Wiring
No. Hydro Massage Tubs winv '• No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current Liability Insurance Policymcludinn Completed Operations Coverage or its substantial equivalent. YES ❑NO ❑ I have submitted
valid proof of same to this office. YES NO LJ If you have checked YES,please indicate the type of coverage by checking the appropriate box.
INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify)
Estimated Value of Electrical Work$ :-).-.)--0 (Exptnon Date)
Work to Start 5=/9-9 y Inspection Date Requested: Rough Final
Signed under the penalties of perjury: !�_
FIRM NAME r:a 80X 30/ 7c2L XplIi/it- Z v 179- OA•7,)-(4 LIC. NO.
Licensee Signature LIC. NO.
/ 4 Bus. Tel. No.
Address N Y1 it � Alt. Tel. No. t- 7 s�--0 5-)
OWNER'S SURA CE W ER: I . aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by
Massachus tts General Laws.and my signature on this permit application waives this requirement. Owner Agent (Please check one)
/�je 7 t Telephone No. 6)f-3U? PERMIT FEE $ ft
( tg ure t n r or A ) 72
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