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HomeMy WebLinkAboutMiscellaneous - 160 FARNUM STREET 4/30/2018 (2) %�c� ���i�/�-c.�r .S�rr���� l�IV Office Use Only { 014c Tommonurettlt4 of isoa#seito Permit No. 10 fi3epa tment of 13uhtir 2pufetq Occupancy& Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TY�P�E ALLINFORMATION) Date 7- 9 City or Town of , l 0 y If e —z- To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) d ` oy;9.R w wAm e Owner or Tenant A�-G 01,60A' 7-& 92 Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building e Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Works GFX No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total No. of Detection and tons Initiating Devices No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices No. of Dryers Heating Devices KW LocalMunicipal ❑Other ❑ Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring i No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES Q/NO ❑ 1 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 appro riate box. INSURANCE OR' ❑ OTHER ❑ (Please Specify) (Expiration Date) Estimated Value of Electrical Work$ Work to Start !?.Z � Inspection Date Requested: Rough �� / Final / Signed under the Penaltieof perjury: �� FIRM NAME //4p ` ' f / LIC. NO. Licensee 10 Signature � � Bus.Tel. No. -7-� Address��� �� � ®�� y / �/ `i ' Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial a alent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owr4W Agent (Please check one) .1/� Telephone No. PERMIT FEE$----- • (� (Signature of Owner or Agent) x-6565 Date...71_-„1 - 1 © 040 HORTM °f, TOWN OF NORTH ,ANDOVER PERMIT FOR WIRING .' r l • ',?a ,SSACMUSEt This certifies that ..... .. ......�.f...`rC/.,<�f ......: ......... ...:. has permission to perform .. ... ..c�l../..l. ...0. . ...:.:.. wiring/in the building of....... ... ... .!'. ......................................................... at:..1!. ��.. 1. r ..� ....:.................... .North Andover,Mass. . Fee Lic.No. .()..�P.�............................... ......... - ELECTRICAL INSPECTOR. U7/II14:30 WHITE: Applicant MAY: ROARing Dept. PINK:Treasurer ,r e .. �. N2 2 : 6 Date....... .. �..... raORTM TOWN OF NORTH ANDOVER F 9 PERMIT FOR WIRING �,SSACNUS�� This certifies that ...... �... .` !�.$. ..............,n.,.,k. —........................... has permission to perform N.....::e:..............�!�t.-P, -k� !/��'�h V-t VJ ..................!!......C..... Ll wiring in the building of k � .................................................U ..... ......................... v �. t� �'`�L 5.............. .North Andover,Mass. at.. ..................... .. . . ..... ....... Fee...���.`. Lic.No. �` ...... ... ......... ............................................................... ELEemcAL INsncr R CV OX0 � 31198 09e03 15.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Office Use only Permit No_ Ad r„1£ ea�razw�.�•r�o;�ss�Crt�rs� s ' D •c P�!![e Sway 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 ulp 527CMR12:00 f (Please Print in ink or type all information) Date C/ To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. 7� Location(Street&Nu7— �49r� ��N ���'LI / • ' Owner or' v v� Owner's Address Is this permit in conjunction with a building J it ' .. Yes ❑ No ❑ (Check Appropriate Box) qurpose of Building �� rev /yr Utility Authorization No. 6-asting Service Amps G Volts Overhead ❑ Undgmd Cl No.of Meters New Service Amps Volts Overhead ❑ Undgmd ❑ No.of Meters Number of Feeders and Ampacity It I_acation and Nature of Proposed Electrical Work 19 L Total No.of Lighteng LightenOutlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures Swimming Pool gmd ❑ gmo ❑ Generators KVA No.of Emergency Lighting 'l No.of Receptacles Outlets No.of Oil Bumers Battery Units 1 No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Dioosal No. Pumas Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers Soace/Area Hearing KW OetectionrSounding Devices C. Municipal ❑ Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Badases Winn No.Hvdro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Cor Meted Operations Coverage or its substantial equivalent YES kNO = have submitted olid 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) (Expiration Date) Estimated value of ectri World �/ �� Wor%to Start (yInspection Date Resquested Rough �+ Final / FIRM NAME theSigned under Ratti erjury:. J SL ,J LIC.NO. / I ✓ t Licensee % Signature 6 LIC.NO. `, Bus.Tel No. /O IJP Address_`G ` I�/T�O1 Y �. 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 byM P3 achusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE 5 /------ (Signature of Owner or Agent)