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HomeMy WebLinkAboutMiscellaneous - 1483 SALEM STREET 4/30/2018 1483 SALEM STREET 210/106.A-0023-0000.0 i Office Use Only— Permit rm ►.,// Peit No- (JA rte£ e� o-�nf'rf�rr�o;�ss�e,�rs�i7s � ' 9yswrr.�.c Safd�r / Occupancy&Fee CheUcea+ �_ I 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/CCMRt Cy 12:00 Q (Please Print in ink or type ail information) Date / A / / f1 To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Locadcin(Street&Number 14/F,� f6 4)C My Owner or Tenant M#!1 - Owners Address r 5/Se 3 ,3/91 epy) s7— Is /Is this permit in conjunction with a building permit Yes ❑ No &--(Check Appropriate Box) / Purpose of Building Utility Authorization No. 3,37 Existing Service O C� Amps Volts Overhead 0' Undgmd ❑ No.of Meters New Service 60 Amps 10 4/6 Volts Overhead ❑ Undgmd m! No.of Meters Number of Feeders and Ampacity a Z d06 Location and Nature of Proposed Electrical WorkC�jll'�Ifb>r �x 'S!s�G ©�/e!Z C/ 1`I) Cfe l//i �d U'-woe Ill 6,qo V vv/J Total No.of LJqht8ng Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Ughtinq Fixtures SwimmingPool gmd C grnd C Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Bumers Battery Units No.of Switch Outlets No of Gas Bumers FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Canal Tons Initiating Devices Heat Total Total No.of Dioosal No. Pumas Tans KW No.of Sounding Devices Nod of Self Contained No.of Dishwashers Soace/Area Heating KW DetectionlSounding Devices ❑ Municipal ❑ Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Sailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: - INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a curent Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent NO = have submitted valid proof of same to the Office YES= NO = If you have checked YES please indicate the type of coverage by checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) 1/ (Expiration Date) Estimated Value of E1 Il Work$ Work to Start 11 77s Inspection Date Resquested d h r3 Rough Final Signed under thp Penalties of pe'u FIRM NAMEl4��U{{ecj ec% f 11) [G�\� LIC.NO. 6 ��1 6 Llcansee 6 7t' -y A)x gycIL Signature LIC.NO.r-da 3/—G�— Bus.Tel No. Address Alt Tel.No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by,4assachusetts A General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) -10 / 3dC� f Telephone No. PERMIT FEE 5�— (Signature of Owner or Agent) N-0 ,1 H Date...�`.�.3. ........ NOR71� 3:°;�;��`°•°,+o°L TOWN.O'F NORTH ANDOVER _ p PERMIT FOR WIRING ,SSACMUSE� This certifies that ...... ..... .CA J,C U.........EA.nG..s.0.......CO:............... has permission to perform , t .�?.i..t..:F:......... wiring in the building of M:(.Z. Su+Ifs at.... 3....� .� .N'?....J .:................. .North Andover,Mass. Fee.... .G Lic.No..........`. ....................................................... t, ELECTRICAL INSPECTOR 05/14/98 15:10 35.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer