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HomeMy WebLinkAboutMiscellaneous - 115 BARKER STREET 4/30/2018 115 BARKER STREET JJ 2101035.0-0001-0000.0 h I i I I I Pae O=IY _ The Commonwealth of �lassachusetts _•• . _ 1 •, ;: Department of Public Safcty p; „cy s F,.e Q,eckec a BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12"00 3/90 itaave otoak) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK AN work to be perfotmed In accordance with the Macsachuseru Electrical Code, 527 CMR 12:00 n (PLEASENT PRIIli INK OR TYPE ALL INFOR'idTION) Date "/U—7 ! City or Toch of i iL- To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) CK Owner or Tenan Owner's Address l oCf Yes ❑ No ❑ (Check Appropriate Box) Is this permit in conjunction with a building permit: , Utility Authorization N0. Purpose of Building 1 P • Existing Service Volts Overhead ❑ Undgrd❑ No. of Meter's )tl+, Amps New Service Raps / Volts Overhead ❑ Undgrd❑ No. of L`.eters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work R Total No. of Transformers KVA No. of Lighting Outlets No. of Hot Tubs Above In- KVA No� of Lighting Fixtures Swimming Pool grnd, grnd. ❑ Generators No. of Emergency Lighting ho. No. of Oil Burners Baste Unit' of Receptacle Outlets I / FIRE ALUNS No. of Zones No. of Switch Outlets No. of Gas Burners Total No. of Detection and , No. of Ranges No. of Air Cond. tons Initiating Devices Heat Total Total No. of Sounding Devices No. of ' No. of Disposals P=Ds Tons KW No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices Municipal ❑Other No. of Dryers Heating Devices KW focal FIConnection ' ! NBallasts Low Voltage � o, o No. of Water Heaters Si sf Wirin No. Hydro Massage Tubs No. of Motors Total HP OTHER: Z?iSUp?;;CE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantiab '1 equivalent. YESQ�NO❑ I have submitted valid proof of same to this office. YES❑ NO If you have checked YES, please indicate the type of coverage by checking the appropriate box. a l J �-�/ ea INSURANCE tB0� C] OTHER C] (Please Specify) �cpiration ate • � �1.,j� • ' Estimated Value of Electrical Work Work to Start Inspection Date Requested: Rough Final Signed c,.;4er the penalties of per jur;: LIC. FIRM NAME f Signature AI Licensee C �` L g Bus, Tel. No. O Address t Alt. Tel. No. O NER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance ethis permirage or t sub- OWNER'S ub- l stantial equivalent as required by Massachusetts General ws, and that ©Y application waives this requirement. Owner Agent (Please check one) (/JJ PERMIT FEE S /� tt Telephone No. - ,i Signature of Owner or Agent ` s Date... ..... /.. f NORT1,4 10"- 0 TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �SSACHUS� This certifies that ..... .Q.`!Q.R........� .y�G17�c...l.................................. has permission to perform ..A C--'r &al........................................... wiring in the building of.. aAt. .....�1 . .P.�°..�.1. ... ................................... at.... 4R Pf .. ....:...................... .North Andover,Mass. Fee..7 ..:.Il s/... Lic.No l ............................................................ ELECTRICAL INSPECTOR 43/12/98 49:14 35.00 PAID WHITE:Applicant CANARY:Building Dept. PINK:Treasurer