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HomeMy WebLinkAboutMiscellaneous - 140 AUTRAN AVENUE 4/30/2018 / 140 AUTRAN AVENUE J 210/045.D-0171-0040.0 J 0303 Date..".7.....—71/...... oRT" TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SAcHU This certifies that ....... . . . ......................... ............................ ....... has permission to perform .... C— wiring in the building of...... ..................................... . . . ...... ........... ..... .North Andover Mass .....a........ C Fee—�-5 .... ... . .. Lic.No.1" Zy ........./. EcrRICAL iN- L4SPECT0 Check # ,t Commo�uueal o� aeaacetfa Official Use Only cc�� cc77 Permit No. tl U 30 3 .i a1JePartment o�..tire�ervices Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leaveblank) 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: / City or Town of: �J o r+k r�J 0-J 9,-r To the Insp aor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) I Li © A Lk -r(-h A-,tt, Owner or Tenant 5-4 4e,0\ A m au I Telephone No. T7$ -6 3 3 -Oy/$� Owner's Address 5 Yh 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: Install residential security system Completion ofthe.following table may be waived by the Inspector of 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 JNo.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 Pump Number Tons KW No.of Self-Contained Totals: '" """ '"."""""""""'.........I.."""""' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ .Municipal ❑ Omer Connection g Appliances Heatin A liar Security S stems:* No.of Dryers KW No.of evices or Equivalent No.of Water No.of No.of Heaters KW Data Wiring: Signs Ballasts No.of No. 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 Electrical Work: Ll 0 Q (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 and penalties of perjury,that the information on this application is true and complete. FIRMNAME: Nightwatch Protection, Inc. LIC.NO.: 7 0 2 4 C Licensee: Paul DelSignor Signature IC.NO.: 7024C (If applicable,enter "exempt"in the license number line.) �eus.'T11e].No.- 888-722-9282 Address: 22 Briarwood Drive, Westford, MA 01886 Alt.Tel.No.: *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. SSC00000969 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 a ent. Owner/Agent " Signature Telephone No. PERMIT FEE: $ S'� � � -. - �' � y � 2 ' - ' � ; � � r � �. x . Fold,Then Detach Along All Perforations EALTH OF MASS . "= BOARD --wLECTRICIANS —~ FA x - uE EM � .� r SE. TYPE , - _ 0 D o�p�afesstona . _-- 856028 P n-i /Z1 13 W Fold,Then Detach Along All Perforations AUTHORIZED Nightwatch DEALER Protection, Inc. 50A Northwestern Dr.,Suite 9 Salem,NH 03079 Kevin Gilli an 15 Holly St.,Suite 208 9 Scarborough,ME 04074 President toll free(888)722-9282 x121 kg O nightwatch protection.com www.nightwatchprotection.com