EP-79909 TOWN OF DARTMOUTH - BUItDTNGDEPARTMENTRECEIPT 79909
PHONE: 508-910.1820 FAX: 508-910-1838
Name: O n/ � 3 6)4- Property Owner: ✓t`'J `L' Date:/ �1/�
Job Location: / ]" 1 7 rl -,s, / ✓ C- Map: �> Lot: /✓ ✓'
Description General Ledger#'s Ref. # Amount
Building & Building Misc. 01000-441�R.tmoLrh � J /
Electrical 01000 462'1/4 i �r_.. - // R ;
Plumbing &Gas 0100014107 �\ ��`' Jr--
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Trench Safety 0100 -441 1' / i k �.11 '\-?`
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Other Department Revenue 01000- 420 Al,� r;
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THIS IS�NOT A PERMITILICENSEPFOR BUILDING, ELECTRIdAL PLUMBING OR'GAS
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Commonwealth,
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C,ommaruaealbh o aa4aLhudelfe �� ✓
t. *= �gtl c� Permit No.
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t = 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: 12/11/15
City or Town of: Dartmouth 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) 94 Millers Drive
Owner or Tenant Roger Barbosa Telephone No. 508-942-0315
Owner's Address
Is this permit in conjunction with a building permit? Yes CI No ® (Check Appropriate Box)
Purpose of Building Single Family Utility Authorization No.
Existing Service 200 Amps 120 / 240 Volts Overhead ❑✓ Undgrd ❑ No.of Meters 1
New Service Amps / Volts Overhead ❑ Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install 35 Photovoltaic Modules 9.625 kw
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tf T
Transformers KVA
No.of Luminaire Outlets No. of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.ofLmergency 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. o f AlertingDevices
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❑ CoMunicinnectiopaln ElOther
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 Te ecommunications Wiring:
No.of Devices or Equivalent
OTHER:
I I' Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 7••B8@"011— (When required by municipal policy.)
Work to Start: 12/15/15 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 ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Philp McCarron LIC. NO.:A14068
Licensee: Philip McCarron Signature _. LIC.NO.:E34460
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.•5US-93U-14U5
Address: 2 Shaylee Lane Lakeville, MA 02347 Alt.Tel.No.:
*Per M.G.L.c. 147,s. 57-61,security work requires Depaitutent of ublic 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)❑ owner ❑ owner's agent.
Owner/Agent
Signature . .. Telephone No. PERMIT FEE: $
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85 MILLERS DR 79748
GIS#: 15082
Map: 0070 COMMONWEALTH OF MASSACHUSETTS
Block: 0043 TOWN OF DARTMOUTH
Lot: 0026
Permit: Electrical �1". �jo !!k41
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category. ELECTRICAL PERMIT
Permit# 99 f48 ° r
Project# JS-2016-001615 aoe •1664 r'
Est.Cost: —_ '
Fee Charged:S379.00
Balance Due:S.00 PERMISSION IS HEREBY GRANTED TO:
#of Fixtures
Pole# Contractor: License: Expires
Service: PHILIP MCCARRON Electrician Master- 14068A 07/31/2016
Amps' ad Owner: DA SILVA DUARTE&
Volts: Applicant: BAY STATE SOLAR
#of Meters:
SRE# AT: 85 MILLERS DR
ISSUED ON: 30-Nov-2015 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
ELECTRICAL(SOLAR PANELS)
THIS PERMIT MAY BE REVOKED BY THE TOWN OF DARTMOUTH UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
400 Slocum Rd.,Phone:(508)910-1825,Fax:(508)910-1838
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