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Home My WebLink AboutMiscellaneous - 136 GLENNCREST DRIVE 4/30/2018 1 136 GLENNCREST DRIVE ` 210/104.C-0065-0000.0 Date.................................. f �aORTH TOWN OF NORTH ANDOVER PERMITFOR WIRING t �,SSACMUSEt .y J This certifies that .............jg6.4...... 7 ............................. has permission to perform ..�� .��C ... '� ..... 5��/�'2 wiring in the building of...........I Pa.�- Qom. at...��.... ... . ........ ST ,North Andover,Mass. ........ Lic.No..-' . iFee, 14 4............ .'/ ...... ELECfRICALINSPECTOR Check # _ 10435 Commonwealth of Massachusetts Off�Dl�Use Only yPermit No. �. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Cod (M C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / l City or Town of. NORTH ANDOVER To the Insjlect&of Wires: By this application the undersigned gives notice of hi&ohng* tention to perform the electrical work described below. Location(Street&Number) 1–U9eoS7— Owner or Tenant i Sr Telephone No. Owner's Address A-y 1"C Is this permit in conjunction with a buil 'ng 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: A 14 g Completion o the lowing table may be waived by the Inspector o Wires._` 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- ❑ o.of Emergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No. of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pum Number Tons KW No.of Self-Contained Totals """"" " """"" Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:" No.of Devices or Equivalent No. of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of ElectricalWork: — (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 nk force,and has exhibited proof of same to the pe ' iss mg f ce. CHECK ONE: INSURANCE ] BOND ❑ OTHER ❑ (Specify:) I certify,under the pains an ei4alties of er ury,tt t the information on ti s application is true and complete FIRM NAME: ii-- �/v ✓0 (/ C� -tS LIC.NO.: Licensee: Signature-4/-- LIC.NO.: (If applicable, e " empff��l1�i the 1'ens,number lj Al Bus.Tel.No.' Ad Address: J V t46 /h 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 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) ❑owner ❑ owner's Owner/Agent PERMIT FEE: $ / Signature Telephone No. I r � i I I i 1 "S V, t r2 N_0 / Date.....�........................ r t HORT11 q 0?�1_��•'_e400� TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACNus� !1 .iis certifies that ..-:/�7.......................................................................... " � o has permission to perform .'.....' ........................ 1��` � , wiring in the buildingpf ..........: `� �`�� at../ ....: �,.e.t �....'.��' v North Andover,Massm Fee ................. Lic.Nom '24 9?" . ............................................................ ELECTRICAL INSPECTOR l' WHITE: Applicant CANARY: Building Dept. PINK:Treasurer , Office Use Only � Permit N0. /9a9 Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00'7 (Please Print in ink or type all information) Date / — 15 1 —9 J To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number l 36 61 er+ e-4� Owner or Tenant Owner's Address1%� Is this permit in conjunction with aabuilding permit Yes ❑ No)WO (Check Appropriate Box) Purpose of Building I S 16 L I,% 155i9-19'7, T Utility Authorization No. E-csbng Service Amps Volts Overhead ❑ Undgmd ❑ No. of Meters New Service Amps Volts Overhead ❑ Undgmd ❑ No.of Meters Number of Feeders and Ampactty Location and Nature of Proposed Electrical Work lA .rel—o'ey.ZL a2I? V eX— Total No.of Light8rig Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Ugnting Fixtures SwimmingPool gmd ❑ gmd ❑ Generators KVA No.of Emergency ughting No.of Receptacles Outlets No.of Oil Burners Battery Units rte.of Such Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No or Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Diposal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers S ace/Area Heatino KW Detection/Sounding Devices ❑ Municipal ❑ Other No.of D rs Heatinq Dev+ces' KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Batlases Winn No.H ro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I nam a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent Jn): NO = have submitted valid proof of same to the OfflcedM= NO = If you have checked YES please indicate the type of coverage by checking the appropriate box = BOND = OTHER = (Please Speciy) I` — 499 �j p (Expiration Date)Estim Work to Start E aaorltS " I�ecU�DateResquested_7-9 —?f Rough Final-7-9 -9f Signed undeftbp Penalties per)ury: FIRM NAME �J� ! /Nf u LIC.NO. j Licensee/y1�f-1flrt L , - U�9��N Signature LIC.NO. ��" �' No. gig .� Address d/�N'�>/�l/e XTall /�JNo. OWNER' INSURANCE WAIVER: I am aware that the Licenses does not have the Insurance coverage or Its substantial equivalent as required by assachusetU General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE S_�— (Signature of Owner or Agent)