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Home My WebLink AboutMiscellaneous - 159 FRENCH FARM ROAD 4/30/2018 (2) 159 FRENCH FARM ROAD 210/035.0-0083-0000.0 l Date..... r-!.z �'... NORTH - ptt,�w.•14.0 3: pL TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING 1SSACHU This certifies that ........ .........F#4 l U..... has permission to perform .........3 .-. .................. wiring in the building of.!.�'d.ct'!' q..... �Jai D�� ............................ �� `�� ....9,6. ,North Andover,Mass. at...... ....^g ............. y.............. r ?2}9.....30 Lic.No.� � ....... ... ......... .........Fee . . ELECTRICAL INSPECTOR Check N �� 6769 �-\ �At�Jt►dtfrlv�if�Zl�„/ umciai Use umy Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS kRev.9/051 peave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(Iv1EC),527 CMR 12.00 (PLEASE PRINT DV RVK OR TYPE ALL INFORMATION) Date: u\a-aA i)to City or Town of: NDo yQ1 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) Owner or Tenant �o ,r Telephone No. Owner's Address C� Vr Q_n d1 , Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Boa) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ Na of Meters New Service Amps / Volts Overhead❑ Undgrd❑ Na of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the followingtable mg be waived by the Inspector of fres. Na of Recessed Luminaires Na of Ceil.-Suisp.(Paddle)Fans Transformers KVA Na of Luminaire Outlets Na of Hot Tabs Generators KVA Na of Luminaires \ Swimming Pool d. El In-d. ❑ a of Emergency LAPting Battery Units Na of Receptacle Outlets Na of Oil Burners FIRE ALARM4 Na of Zones Na of Switches a. Na of Gas Burners a o tion an InitiatingDevices Na of Ranges Na of Air Cond. Tons Na of Alerting Devices Na of Waste Disposers HeatPumpNumber ons a - ontam Totals: Detection/Ale Devices Na of Dishwashers Space/Area Heating KW Local❑ Coria 'on ❑ Other Na of Dryers Heating APPliane esKW N of or idvalent N&of Water KW a o a o Data Wig: A Heaters S' Ballasts Na of Devices or Equivalent Na Hydromassage Bathtubs Na of Motors Total HP mm dons Na of Devices or Equivalent u OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: c►�. (When required by municipal policy.) Work to Start: (A O lei --11 ob 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 ol£ice. CHECK ONE: INSURANCE E] BOND ❑ OTHER ❑ (Specify:) I certify,under thepains andpenalties ofperjury,that the information on this application is true and complete: FII2M NAME: M,l�, -�. ear ecx,�. Gke ► c, LIC.NO.: 3-1aci y 1Z Licensee: V\(.v\L J. c.\m.-L\ es cx�+- Signa C.NO.: CJ\7-J-i4L (If applicable,enter "exempt"in the lice►tse number line.) Buis.TeL Na: 1n�3 Stu(o GSI Address: ��S TQC. •�� \1r�•'r��S�r�,,, N� AIt.Tel.Na: �b3-•�,�;-y�►�� *Security System Contractor L required for this work;if applicable,enter the license number here: 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 requu eme nt. I am the(check one)❑owner ❑owner's agent Owner/Agent Sivnato Tebmhmie Nn. ! "ERM T FEE.-$3 0.