EP-6599.........m. ::d =
5No TAX ISSUEoGTH
RECEIPTS
COLLECTORS OFFICE
Name: Property Date:
. .
a r Owner:
Job Location - 1k—�u "i-i_-;. 't._ :'2.,•' ..,_ram_.._ , ...T
White Copy-Collector's Office
Yellow Copy-Customer's Receipt
Plot: Lot: l Pink Copy File Copy
Green Copy-Building Department
Phone:
Description General Ledger Ws -. - roMdrbkRiMOVH Amount
License&Permits-Building 01000-44105
License&Permits-Building Misc. 01000-44105 J N N 2 1998
License&Permits-Electrical 01000-44106
License&Permits. Plumbing&Gas 01000-44107 C S G 07
Other Department Revenue 01000-42420
This is not a Permit or License for Building,Plumbing or Gas Received By:
M
C
TOWN OF DARTMOUTH
BUILDING RECEIPTS
COLLECTOR'S OFFICE
Name: Property Date: -
y s y i
- __ z-:---C-4:. Owner: - .4-- v .: r _
Job Location:
White Copy-Collector's Office
Yellow Copy-Customer's Receipt
Plot: : Lot: t;' f_ . '
f { ,_ Pink Copy-File Copy
Green Copy-Building Department
Phone:
Description - General Ledger#'s Ref.# Amount
License&Permits-Building 01000-44105 COLLECTOR'S OFFICE
License&Permits Building Misc. 01000-44105
JUN 2
$License&Permits Electrical 01000-44106 ,
License&Permits Plumbing&Gas 01000-44107 C S G 07
Other Department Revenue 01000-42420
This is not-`a Permit or License for Building,Plumbing or Gas Received By: `f `
Office Use Onh. `f
The Commonwealth of Massachusetts PermitN.O. '� (---3 i �s
I. " i Occairnry 4&'Fee checked `,
! 3 Department of Public Safety 3/90 j (ka>+er blank; ,
f 4- ,,--
� BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1100
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed In accordance with the Massachusetts Electrical Code. 527 CMR 12:00
(PLEASE PRINT IN INK OR 2XYE AT.T INFORMATION) Date May?291 1998
City or Town of Dartmouth To the Inspector. 5 Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street k. Number) 26 Sundancc Rd '
Joe Carrier /' 4
Owner or Tenant ,
Owner's Address Same
Is this permit in conjunction with a building permit: Yes C No Q (Check Appropriate Box)
Purpose of Building Utility Authorization NO.
Existing Service Amps I Volts Overhead I J Undgrdl._._ No. of Meters
New Service Amps / Volts Overhead Undgrd E No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work Wire & bond above ground pool, inst rec_ for
pool light.
No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total
KVA
No. of Lighting Fixtures Swimming Pool Above In-
grnd. . grnd. Generators KVA
No. of Receptacle Outlets No. of Oil Burners Bat of Emergency Lighting
Battery Units
No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones
Ranges No. of Air Cond. Total No. of Detection and
No. of Ran
gtons Initiating Devices
No. of Disposals No of Pumps Tons KW Heat Total Total
.
P No. of Sounding Devices
No. of Dishwashers Space/Area Heating KW No. of Self Contained
Detection/Sounding DevicesMu
No. of Dryers Heating Devices KW Local® Connectiopal Other
Cannection
KWNo, of No. of Low Voltage
No. of Water Heaters
Signs Ballasts Wiring
No. Hydro Massage Tubs No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial
equivalent. YESiii NO 0 I have submitted valid proof of sane to this office. YESII NO 0
s If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE Ek BOND ® OTHER ❑ (Please Specify) �[���Jq�,
~K''ixpi ion Date
a Estimated Value of Electrical Work S
Work to Start ,' e2 Inspection Date Requested: Rough Final/
Signed under the penalties of perjury:
FIR.N NAME John Sulvma Electric, Inc. `` J� LIC. l+''• A117
Licensee John P Sulyma Jr Signature `r ;�4%',n:1+rZ L°d/7, ,�j, LIC. NO. 00
Bus. . No.
Address 1203 Chaffee St New Bedford MA (12745. JJJ 508-�98-3$82
Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub-
stantial 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 S 30.00
(Signature of Owner or Agent)
BC•44A
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