HomeMy WebLinkAboutMiscellaneous - 1600 OSGOOD STREET 4/30/2018 (72) ' 1600 Osgood Street \
Building#48
Date. ..........'.G.........
l f HORTM 1
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
s'SACMUSEt
This certifies
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has permission to perform *', n:-:,:: ;:�;,:,r.-•-f - p✓
wiring in the building of.. �"' 'r+f-
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.......................�.t..� ......................� . .......... ,North Andover,Mass.
Feeiew.......... Lic.No.......0.. ......
ELECTRICAL INSPEfMR
Check #/`)J� r
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Commonwealth of Massachusetts Official I.Ise Only
[Permit No.
Department of Fire Services
Occupancy and Fee Checked Z
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9!051 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance«ith the Massachusetts Electrical Code 0,1EC). 527 CMR 12.00
(PLEISE PRINT 1N hVK OR TYPEALL IN ORXMTK)N) Date:
City or Town of: 161 o.E'Od� To the I ivpeaor ol'Wires:
By this application the undersigned gives notice of his or i r intention to pe form the electric I work described below.
Location (Street& Number) r Q G� �J l
Owner or Tenant ./ r: elephone No.
Owner's Address ov ��
Is this permit in conjunction with a building permit? Yes M-- 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
Locatiou and Nature of Proposed Electrical Work- 1 car{'
f
-Completion a the following(able ntcty he wuived by the lis ector of iVires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle) Fans No.of TotalTransformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Above In- o. o mergeney Lighting
No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones
No.of Switches No.of Gas Burners No. I Detection and
� Initiating Devices
No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices
No.of Waste Dis posers Heat Pump Number Tons KW No.of Self-Contained
. .. ....... .................................................
p Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection
El Other
No.of Dryers Heating Appliances KW Sec uritNo.of Devi es or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:No.of Devices or Equivalent
� OTHER:
I ouch acklitional detail i/'desired, or as reyuirecl by the Inspector of ft'ires.
Estimated Value of Electrical Work: (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.
CFIECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains mid enult�of perji P,that llie iii urination on this application is true and coniplele.
FIRM NAME: 1: % LIC. NO.:/3M
Licensee: Signatur _ ALA,S� LIC.
gfapplicuble, cutter in the l "ise i tuber line.) ^ Bus. Tel. No. fsPl -7:i 'a
Address: �/ :11t.Tel. No.:
*Security System Contractor Lice .e required for this work; if applicable,enter the license number here:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee clues not hime 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 accent.
Owner/AgentPERMIT FEE: S 4JZP:S' _
Signature Telephone No.
�yueinus�v�ur rvhnrut: �► Permit No.
BQARDOFFIREPREVffM VRBGi11A7M527aMZZlX
PMry&Fees Clicked
APIUCARONFOR PERMITTO PERFORMELEMUCAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WTM THE MASSACHUSSTS ELECrR1CAL COD8,527 CMR 12;00
(PLEASE PRINT 1N INK OR TYPE ALL IN
Town of North Andover
To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location(Street 3 Number)
Owner or Tenant V
Owner's Address
Is this permit in conjunction with a building permit: Yes No ✓ (Check Appropr ata Boa)
Purpose of Building Utility Authorization No.
Existing Service Ampq / Volts Overhead Underground No.of Meters
New Service I - Is�' - 6/7 Overhead Underground C3 No.of Meters
Number of Feeders and Ampacity [J
Location and Nature of Proposed Electrical Wort
Na of Hawing Ondau Na of Hot Tuba X.ofTmmhnm. TOW
Na of Liandna Piatma Swimming Pool Above Ba KVA
Una KVA
No.of RwApucb Oudot No.Of 011 Rutose No.of Emervaq Ughdna Emmy tlaits
Na of Switch OOdeu
No.of Ott flumen
Na of Ramat Na of Air Coad. ToW FIRE ALARMS No.of Zones
Toni
Na of Dbpoub Nm Of Hat Told Told Na of Ddectioa and
POMP TOM KW WdeftDowim
No.of Dishwuhmf Space Ma Heuhna KW Na of Sounding Daren
No.of Self Coeuahwd
No.of DryerHestina Devices KW tour Dmuwcipd Ot
bw
No.of Won Heuem Kw No.at No.of ComudoM
silum Bail"
No.Hydra Muasae Tubs No.Of Motor Told HP
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