EP-173 Report ; Fee pd $ 70.00
Owner Mike Ferreira Date 10/6/92
Address 18 SUNDANCE RD. , N. DARTMOUTH 79/48-27 PermitNo. 173
Contractor Frederick D. Souza 26099E (401) 253 037674 Red
Address 10 Jenniker Dr. , Bristol RI 02809 B' -6, 61'2
Remarks New Dwelling: 200 amps. , 240 volts, 1 meter, 16 lt. , 16 fix,
.t . 50 rec. , 35 sw. , 1 range, 1 dishwasher, 1 dry.
1 massage tub, 1 oil burner, 2 motors.
Est. value: $3,500.00 /,
Rough ready 10/7/92 k(}-7
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1V6 - - -�-- /0
Inspected By: Date
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WMR WR INFO WORK REQUEST INFORMATION PAGE 1 OF 1
NOV 02 , 1992
Work Request No : 36665 Entry Date : 13-OCT-92 Req . Date : 23-OCT-92
Entered By : MELLO , JACQUELINE A Rate/Rev Code :
WR Type : NEW SERVICE WR Status : DES
WR Description : UC/RES--200A U. G, SERVICE APPROX 200 ' FROM HAND HOLE
WR Name /Customer : FERREIRA,MICHAEL
Service Address : 18 SUNDANCE RD Acct#: - -
City : DARTMOUTH
Pole/Pad/MH No : 10072/120A Lot : Plot :
Designer : ALMEIDA, JOSEPHINE A .
CONTACTS Name Type Phone No
10 JENNIFER DR, ELECT ( ) - x
BRISTOL RI 02809 ELECT ( ) - x
F & S ELECTRIC INC ELECT (401 ) 253-0396 x
ELECTRICAL
REQUIREMENTS Service Voltage : 120 /240 3W 1PH Number of Meters : 1
Amperage : 200 Type of Heat :
Phase : 1 Meter Number :
Service Location : ELEC. TO TERM. SERVICE AT HANDHOLE. HE WILL
ALSO LEAVE 4 ' OF CABLE AT EDGE OF HANDHOLE F(
LT. CO. -CONNECTI.ONS . ` TLM#293423
Office Use Only / j 3 /
The C monwealth ofMassachtts Permit No. l
4._ _ , Occupancy&Fee Checked_ /P'2� 7 O
A (leave blank/0- 6,
� Department of Public Safety
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
���/ i
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date / G�-
The undersigned applies for a permit toperform the electri al work described below. �?
Location (Street&Number) �' 5� / � eC < L jOi=-,,f/• l7 - y
Owner or Tenant / l4 i1ez..- ''
Owner's Address /-S ¢- 5x C.
Is this permit in conjunction with a building permit: ,� Yes Er-No No ❑ (Check Appropriate Box)
Purpose of Building S,714, 7.); �e .,.,- k.�f Utility Authorization No. 3,20(5'
Existing Service Amps — / —Volts Overhead 0 Undgrd' N . of Meters C'
New Service '0 Amps /,?° / mod/9C Volts Overhead ❑ Undgrd .L. No. of Meters
._ 7�Number of Feeders and Ampacity 3 0 / L )oO 4
Location and Nature of Proposed Electrical Work (i-/ Avers-, <A Lis€
No. of Lighting Outlets /(7- No. of Hot Tubs No. of Transformers -- Total
KVA
• No. of Lighting Fixtures �� Swimming Pool--ode ❑ g d ❑ Generators -- KVA
No. of Receptacle Outlets No. of Emergency Lighting No. of Oil Burners / Battery Units
No. of Switch Outlets No. of Gas Burners -- FIRE ALARMS NO. of Zones
Total No. of Detection and
1 No. of Ranges 1 No. of Air Cond. Tons Initiating Devices
Heat Total Total
No. of Disposals 0 No. of Pumps Tons KW No. of Sounding Devices •
Space/Area HeatingKW No. of Self Contained
No. of Dishwashers p Detection/Sounding Devices
HeatingDevices .- KW 1-1 Municipal
No. of Dryers / Local Connection ❑ Other
No. of Water Heaters KW No. of No. of Low Voltage
Signs Ballasts Wiring 7C�<< oN,p —A. ' Cif-.ems
No. Hydro Massage Tubs / No. of Motors sZ Total HP g/4 +
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws ��
I have a current Liability Insurance Polic udin Completed Operations Coverage or its substantial equivalent. YES [ NO El I htra a submitted
valid proof of same o this office. YES IJ NO [ If you have checked YES,please indicate the type of coverage by checking the appropriate box.
r / //
INSURANCE BOND ❑ OTHER El (Please Specify) �E , 'i7/its A`�
✓SZ v,5� 0/, 1 (Expiration Date)
Estimated Value of Electrical Work$
Work to Start /9/4, /?. Inspection Date Requested: Rough / - 7 J Final
Signed under the penalties of perjury: - .
.- 1 / GZ.
FIRM NAME E' t G �l7L�C / LIC. NO. v r
Licensee f� E��9i<--/{ - S z 4 . Signature .1 ,fg LIC. NO. cP6. `''J`L-
_ Bus! Tel. No.
Address / "tW 1 ) - %IIl vac d) ' 9 Alt. Tel.No. 'O/�a.r Z of 2 G
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)
Telephone No. PERMIT FEE $
(Signature of Owner or Agent) p /
RECEIPT FOR PERMIT 1
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TOWN OF DARTMOUTH / 7 163
PERMIT NO. I
No
Date
2
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