EP-153 Report Fee pd_ $70.00
Owner Paul Medeiros Dat9-9-88
Address 6 South Wind Way Perm' No. 153
Contractor �gt p % Red
Wayne H_ Tavares
Bl e
Address 608 Broadway, Fall River_ 02724 /y� ✓ s y
Remarks wire new dwelling 200 amp, 120/240, range, oil heat
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Inspected By: Date
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The Commonwealth of Massachusetts Permit No. /i , �/
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BOARD OF FIRE PREVENTION REGULATIONS FPR•11, RULE 8
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
Town of Dartmouth
All work to be performed in accordance with the Massachusetts Electrical Code, FPR-11
Date 77 19 If
To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number 1i ( h iati i/a Pole No.
Owner or Tenant f g!!.( 17¢.PC/ '5
Owner's Address <>4 7/7
Is this permit in conjunction with,, //
a building permit? Yes No
Purpose of Building /YP/id 4i/V„4
Service ,, DV Amps / . 1°/CI volts No. of Meters
Existing L---- _ New Increased from to
Nature of the Proposed Electrical Work �i p t'r ft%'&7434 / (it '' %c'/
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PROPOSED FIXTURES IN DETAIL(See attached schedule, if necessary)
Light Light
Location of Room Outlets Sw. Plugs Fixt. Location of Room Outlets Sw. Plugs Fixt.
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No. of Sw. Out. Heat—Type
No. of Outlets Lt. Oil IV
No. of Rec. Gas
No. of Motors H.P. Electrical —KW Connected Load
No. of Signs Trans. Hot Water—Motors and Size
Air Cond. -Steam—Motors and Size
Range Name Plate Rate - Hot Air—Motors and Size
Water Heater Name Plate Rate Misc.
Clothes Dryer Name Plate Rate
Total Load
Size of Main Entrance Sw.
Size of S.E. Conductors y�
Work to Start ?/q/P3 f Inspection Date Requested Permit Fee _
Signed under the Penalties of Perjury: / T�}
Licensee /✓G�'4 y/71 AL i;u/9/2 r.'5 Signature /// zy1q `u724''"� License No. , •7/ , /
(Please print) ,�' (Please sign) l x �r
Address,„ i^ii4hnr-L7 /////L/fir / �- /f Tel. No./ _2 �J
(Street&Number) (City or Town) (Zip Code) /
Supplemental information on forms furnished by the inspectors of wires shall be mailed or delivered by the applicant within five(5)working days
from the date of said.application,if required by the inspector of wires.
TOWN OF DARTMOUTH
WIRE DEPARTMENT
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,e Name ,_614"4-ent of Amount
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