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Home My WebLink AboutMiscellaneous - 100 ANDOVER BY-PASS 4/30/20181\ Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 16-'16 I Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. ]/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: July 26, 2010 City or Town of. NORTH ANDOVER 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) 100 Andover By—Pass Street, 3rd Floor Owner or Tenant OB/GYN Women's Care Telephone N6781 —756-2504 Owners Address 100 Andover By—Pass Street,, 3rd Floor Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the following table may be waived b the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: (Paddle) Fans of Total TransSusp. Trsformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑In- ❑ o. o mergency Lighting rnd. rnd. 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 Tons No. of Alerting Devices No. of Waste Disposers Heat Pump I Number I Tons KW No. of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal El Other Connection No. of Dryers Heating Appliances KW SecuritySystems: No. of Devices or Equivalent No. of WaterK� No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: 39 No. of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: $1 0 , 6 2 2 . 0 0 (When required by municipal policy.) Work to Start:0 8 / 0 3 / 10 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 ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: NECOM — New England Communication Systems InbIC. NO.: Licensee: Signature LIC. NO.: (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-658-670 Address: 60 Jonspin Road, Wilmington, MA 01887 Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I a%,are the Licensee does not have the liability insurance coverage normally required by law. my signa low by aive t s requirement. I am the (check one) ❑owner El owner's agent. gna ure el o eNo. 978-658-670 ERMITFEE: $125.00 ��& 2, Lo IQ -c- 9561 Date........ ....... Inzo TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..................... A) ce) has permission to perform wiring in the building of..o��G x. �c ............. on:E at :. ............... ej� North Andover, Mass. foa P"dLic. No. ../V74 . ........... ................/. / . ..... . ......... ELECTRICAL INSPE(Ci'oR Check # .t t s_ Commonwea& of /Y/aajachuaelb Official Use Only . •� y 2epartnwrd of 7ire Service9 Permit No. t Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] Oeave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CY[R 12.00 (PL E4SE PRINT IAI Al lK OR TYPE ALL LYFOR414T10A) Date: 7 30 -/0 City or Town of: % 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) /0V /�f,�/�� ;J �' �/ �/,/��1 <, Alp lel, jY�j��e? vel-ly— Owner or TenantTelephone No. Owner's Address 100 Ajjo, Pa� �,ra f'fj PO j& /%� AIXI")IG% U e c Is this permit in conjunction with a building permit' Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utilitv Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑In- ❑ rnd. rnd. r o. o Emergency Lighting Batter Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. o Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number I Tons IKW ..... No. of Self -Contained Detection/Alertine Devices No. of Dishwashers Space/Area Heating KW Local [:1 Municipal E] Other Connection No. of Dryers Heating Appliances KW ty ms: ecurt S steNo. of Devices or E uivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach adddronai detail it desired, or as required by the lnspector of Wires. Estimated Value of Electrical Work: CIS (When required by municipal policy.) Work to Start: 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 ❑ BOND ❑ OTHER ❑ (Specify:) I certify,, under the pains mtd penalfies of perjury, that the information on this applicafiott is true and complete. FIRM NAME: American Alarm & Communications, Inc. A,, LIC. NO.: 1 2 1 2 C YI A Licensee: Rich a r d L. Sampson , Sr. Signature LIC_ NO.: 5 0 2 D (Ifapplicable, enter "exempt"in the license number line.) iw Bus. Tel. No.: 781-641-2000 Address: 297 Broadway, Arlington. MA 02474 Alt. Tel. No.. *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. SS CO 000090 MA 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) El owner El owner's agent. Owner/Agent PERMIT FEE: S Signature Telephone No. a 95'/ 4 Date.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that............. 4111 has permission to perform ........... � . ..... .......... wiring in the building of ........ . ..... ...... A 5........... North Andover, Mass. Fee...... No. 1.�.12-.' . . ............ . . .... ................. .. ....... .... If -� L i�s��C2 ELECTRICAL SPE r i C Check# 934