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EP-391 Report Ce1 �� Fee pd $ 70.00 Owner Coluciello �il�L'� LS Date 12/4/91 Address 6 KNOLLWOOD DR. , N. D. 74/5-3 PermitNo. 391 Contractor Eric Sylvia 13901 67 7 0527 yellow_,,„. Red Address 2 Weaver St. , Fall River, MA 02720 c ,ia ?i Remarks Service and finish for MODULAR HOME. 200 amps. , Est. value: $650.00 / Will call. ()sage AZ4 Inspected By: Date /02-3 / /o; 5-6 7-71 C4..e14.1. / o : 9; //,' 3 0 y The Com nwealth of Massachuset Permit No. Office Use Only t = t Occupancy&Fee Checked O -e _(:lefil Department of Public Safety (leave blank �y —� eCti 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 / 3— 2/ The undersigned applies for a permit to perform the electrical wor escribed below. /� Location (Street& Number) to ��©I/ tv.fi' e l t S-3 /J Owner or Tenant ` o lzr l i 2 //c, Owner's Address • Is this permit in conjunction with a building permit: Yes Ft No El (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead [1 Undgrd ❑ No. of Meters New Service —.W.,'r7 Amps //0 / /4ZD Volts Overhead ❑ Undgrd , No. of Meters / Number of Feeders and Ampacity T� ._ 7i"�/7/4x —r✓l Location and Nature of Proposed Electrical Work "5 — . Po�� a�L 44:51.717/co.,/� No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA f No. of Lighting Fixtures Swimming Poold e ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting kg ..3 Battery Units No. of Switch Outlets 5 No. of Gas Burners FIRE ALARMS NO. of Zones Total No. of Detection and No. of Ranges No. of Air Cond. Tons Initiating Devices ToNo. of Disposals No. of P um Tons KWl No. of Sounding Devices Space/Area HeatingKW No, of Self Contained No. of Dishwashers P Detection/Sounding Devices No. of Dryers Heating Devices KW ❑ Municipal ❑ ry Local Connection Other No.of Water Heaters - KW _- - No. of No. of Low Voltage Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP ilevet OTHER: ,/' till INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws ,,��,, I have a current Liability Insurance Polic includi,n,_gg Completed Operations Coverage or its substantial equivalent. YES_d'NO ❑ I haye submitted valid proof of same to this office. YES DNO L i If you have� checked YES, Y� ES,,plle7ase indicate the type of coverage by checking the a propriate box. li INSURANCE BOND ❑ OTHER ❑ (Please Specify) 2)✓/'`P P i S uG�.v 70'i — c% �s� Estimated Value of Electrical Work$ 1.Sri ��j / ( xpsauon Date) Work to Start /2-� Inspection Date Requested: Rough Mit/? // `/1/7 Final Signed under the penalties of perjury: FIRM NAME �--S n �i'c r-,----- ,:-40.-^, 'f LIC. NO. 7.35�� Licensee i4.l� Signature r&-, �.sJ LIC. NO. 3V/S.3 /�� !!! j�Bus. Tel. No. Address o2 Gci-e/1vP/ ..l"/. —��,J /l�� Oa?=-2c7 Mt. Tel. No. eg 77 0 ate' OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) �1 � c (Signature of Owner or Agent) Telep one No. PERMIT FEE $ 2V RECEIPT FOR PERMIT 7 �� TOWN OF DARTMOUTH 39 f 1 PERMIT NO. No Cites < 7 R / / I Date / -•"V -/� t I, Received From eta...—. ' -. Owner ��.a-L-L/c_-t_¢�e C_.l� i f�// Location � ' /•7 '. T9pe o ` c 7/ 7 Amount Paid �~ "� Received By Lt -'C--a'-t-Q--4 G �* r'-'� (--.