Loading...
HomeMy WebLinkAboutMiscellaneous - 1600 OSGOOD STREET 4/30/2018 (59) � �� .._ .� i --- �-- i q Date.... ........a. ... HORTry °!t"`°:•�"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SS�CNUSEt This certifies that ..........:1.:t &�.................c7�� C �................... ... ................................ -�- has permission to perform .. �!a ���� �. n'��'�, . ..................... ..... ................ .................. icl�oa��GOG , 1 wiring in the building of. ................................. .. ...� ................................... at..... b .. rit!sa T-` �LoT'orth Andover,Mass. Fee. t��^ .. Lic.No.�6 5 13!9 ..- .... EcrmcALINSPECTOR / Check # 71r133 8288 ✓ r� Commonwealth of Massachusetts Official Use Only Permit No. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: 61 -010e City or Town of: NORTH ANDOVER To theIn peC or of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 1600 0 s96 d A Sfi Owner or Tenant T�J coy!, ` AbT Telephone No. 1C L Owner's Address [boo p 4.r Penn Is this permit in conjunction with a uilding permit? Yes No El (Check Appropriate Box) r Purpose of Building�%,JC a4j Ce = i fn Utility Authorization No. b Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: RZ ",t f ekA COa"acrt © f GOO 6S104A S �► o- cc '1`j tv" 06A L o 0 Completion of thefollowing able may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA t No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In F-1o.o Emergency Lighting rnd. rnd. Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection Heating Appliances Security Systems:* No.of Dryers g pp Kms' No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent 3 No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: r � Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of El ctrical Work: o(�o (When required by municipal policy.) Work to Start: 13 7 05 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C RAGE: 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 cov rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE EJ BOND ❑ OTHER ❑ (Specify:) I certify,under d e pins andpenalties o`f_perjury,that the information on this application is true and complete. FIRM NAA L_L LeN1i c tjC t LIC.NO.: 6 Licensee:w v\,< I.,q v� . SD y 2t.1 Signature W. LIC.NO.: (If applicable, ente " xempt"in the license number line.) �l Bus.Tel.No. (?3-765`"f 729 Address: �,"? f'6t!, Aue, -S(<m KV � 0367q Alt.Tel.No.: *Per M.G.L c. 147,s. 57-64,security work requires bepartment of Public Safety"S" License: Lic.No. 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 requirement. I am the(check one) ❑owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. 1 f i I i I I i � I , . :; �� �. �� r