HomeMy WebLinkAboutMiscellaneous - 16 CLEVELAND STREET 4/30/2018 16 CLEVELAND STREET
210/029.0-00240000.0
N° 2 7 1 f Date.......1..� ..�✓ ,( !
f MORTM'1
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
-TS ACNUSE�
This certifies that ...... .:..V �.�l 54..�.......✓. C....... �Q/t FYI.5......
has permission to perform �.� 11.E � �
wiring in the building of.......�... `` ..S F I
at...........kl......C.t P.l�. ..l..a. ....�C ...........,North Andover,Mass.
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Fee ?�j ,Jc�.. Lic.No...l.�����........�'�' , �. ..,..
ELECTRICALINSPECTOR
Check # V�
G'
WHITE: Applicant CANARY: Building Dept, PINK:Treasurer
K 2
CIMOzon4w, ealK Official Use Oni
Permit No. 7�/
ern
BOARD OF FIRE PREVENTION REGOccupancy and Fee Checked
REGULATIONS I(Rev- 11i9q] ticave blank) -------
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to beperformedin accordance with the Massachusetts r-lectricni Code(NIEC),527 Cl,,,R 12.00
(PL-',ISL PRINT LV INK OR TYPL.--4LL mroxv,-i my)
City or town of:
N. AndowX To the Inspector o PVjj-eT:
By this application the undersigned gives noticcorlits orhcr intention to perform the electric' �f
Location (Street&-Number) 01p . rricak work described below.
Owner or Tenant 0 Telephone &
Owner's Address
Is this perirdt in c0njunctio.ti with a building permit? Yes No
j2rJA (Check Appropriate Box)
Purpose or Building tuvq_l Utility Authorization No.
Existing Service
Anips Vo.Its Overhead El Undgrd 0 No.ordeters,
New Service
Anips Volts Overhead❑ Und-rd ❑0 No.of Meters.'—
Nurnber of Feeders and Anipacity
Location and Nature of Proposed Electrical Work:
-20212leti0l,o(the follolving table inav be ivaired by the himccroro0virer.
1 .01
No.of Recessed Fixtures 0.of CeilSusp.(Paddle)Fans 170121
No. of Lighting Outlets No. transformers KVA
No.of Not Tubs Generators K.VA
Above
No.of Lighting FL-Ltures I—In- , mergency Licht
Sivin:iming Pool Ing
z:1 arid- grnd. Battery Units
No.iof Receptacle Outlets
No.of Oil Burners FIRE ALARNIS JiNo.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Total Initiatin-Devices
No.of Ranges No.of Air Cond.
Tons lNo. of Alerting Devices
No.of'Waste Disposers HeatFunip iNumber ITons IKW No. of Self-Contained
Totals: IDetection/Alerting Devices
es
No.of Dis.hir.2shers Spac&Are2 Heating XNYLocal
❑ ')"uu'c'Pai f-1 Other
Connection
lNo.of Dryers He=tin-,Appliances KtiV Security
Systems:
IN 0. of Water No.of No.oCDevices or Eguivalent
Ile KI Data IvAliring:
nters I
Signs Ballasts f No.of De-,ices or Equivalent
lNo.Hvdroinassage Batlitubs No.of Motors Total HP 1—"Telecommunications Wiring:
No.of Devices or Eauhzlent
OTHER:
4tracd additional detail if desired, or as required by the Insvector of Wires.
INSURANCE COVERAGE: UnIcssxraived by the1
er,no permit for the performance of electrical work may issue unless
the licansec provides proof of liability insurance including completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force,and has=dlibited proof of same to the oermit issuing office.
CHECK ONE: 11NSURj\NCE ;R' BOIND [3 OTHER 0 (Specify-)
Estimated Value of'EIcctrical Work.* 'WO-0 (&.piration Date)
(When required by municipal policy.)
Work- to Start: t Inspections to be requested in accordance with INIEC Rule 10,and upon completion.
I certify, under the pains and penaltiesa pedur rnzalfon an this application true and completes
FIILNI NAIN r,that 'I e il Ifo
-IC.NO.:
Licensee: /1 /7 9( Signature LIC.NO-44664-3 C-
To,:
(If applicabi cr. e-N,,V4 t /ice inunberil PA
Bus. e.1 o.-
Ai T I'IN
Alt.Tel.1NoJr/-' -A
0' INSURANCE WAIVER: I am aware that t1te Licensee does not Irene the liability insurance coverage normally
required by law. By my signature below, I hereby waive this requirement. I am the(check onc)C1 owner C]owner's agent.
Owner/Agent
ty
Signature Telephone No. FLRt3IIT FE-E: S-
DEPARTMENT OF PUBLIC SAFETY
License: SEC SYS CERT.CLEARANCE
E
�s Number. SS CC 001375
F Birthdate: 10/07/1942
Expires: 10/072001 Tr.no: 31
Restricted To: 00
RICHARD J HUGHES
937 R WEBSTER ST
MARSHFIELD, MA 02050 Commissioner DIG SAFE CALL CENTER: (888)344-7233
i
COMMONWEALTH OF MASSACHUSETTS
OF ELECTRICIANS
REGISTERED MASTER `ELEC-TRICIAN
fssuES Tws uCExSE,o
' UNIVERSAL SECURITY ALARMS "INC
•RICHARD J HUGHES0
937 WEBSTER ST
J 2ND FL
MARSHFIELD MA 02050-3442•
17030 A 07i31i01
201174 - --
'� •FOIL.Tnen Deuc, • • • t - - - - -
Aiong Ail Perforations
co►�n-�oi 0 8 6 4" 8-0
f -
tf IMPORTANT -
If this license is lost or destroyed, notrfy your Board at the f
Division of.Registration, 239 Causeway Street Suite 500, lz
:-.Boston,MA 02114. -
If.narne or address shown hereon is changed not
- '
M {c
Your
board of corrector address to insure proper mailing
i of next:Renewal ADPlicaiion.Always refer to your license
r number License issubject to provisions of the GeneralyL,aws
Y
a Personal Privilegemust not be.,'an _ sal f y��+
d f
loarle�m assigned to
i Yo�person'or an otherPerson.Keep this license on
}a t r
Posted as required
a r .
by law. - '` ''•� -� � ! < _ :� `} u
.-
Fdd.7han Detach Abno All Pert - --...-- - - _ •.:� s, ' - y i .�-•`` t` ,%r f'. T^ x✓�,-
.. _ . . orations' - _ .. _rspn-. .s_ ?;?�.',t.s•.-i .>f