HomeMy WebLinkAboutMiscellaneous - 266 LACY STREET 4/30/2018 (2)N
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Date �7 - �? ��.
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that J� g7 ...................
has permission to perform ... ..... /,?� ...........
wiring in the building of 1.9 -7 "S .......
at North Andover, Mass.
Fee. . ��."Lic. No. ... ... ...
ELECTRICAL INSPEUTO�
G. ck 4 12
10981
Commonwealth Of MOSSachusettg
�ftPaftmentof Fire Services
BOARD OF FIRE PREVENTION REGULATi s OccuPamy and Fee Check -6d
V 1, 40 71
ONS F
aw_ve qJwk
APPLICATION FOR PERMIT -TO PERFORM
AN wc* to bapw&rmed iu =mdace with the massachusetu L ELECTRICAL WORK
(PLEA 0 PMT. M AW 0, R 27 YPE, UZ R &ORA U WOV noc'41W COdO MQ, 527 CUR 12.00
Date: x z_
ChY Or TOwn Ofi NORTHeMOVFR
By this aMlication the TO the Insp
N,LVI= MOUM M VMS W law ecAlor of Wires:
LOCatift (Sbwt & Numbw) !'�UDU Zo jXr%fM ft O]WtriCW wo* dmnbed below.
Owner or Tenant Ce
OWAWs Address Telephone.No.
.7 --- I
18 ttis Permit 10 '004102edon vPi& it bal perml
Purpose af3mudbw Yes Ep___N_0 0 (Check A
Exisdug Service wts Utift Autherftaton No -------------------
Overhead B---Udgrd NO. Of Meten
Amps Volts Overhead 13 Undgrd 0 � _Z_
Nizzabeir of Fwderx and Ampacity No. of Meters
LOCAtlQu and Nappm of Propond
Electrical worlo.
of Recessed Luml
kfo. of Luxaluaire onjito
�. of R"tade Outlets
I. of Switch"
of Rumes
Of Waste Dispoml
.of fthwshm
-1 ----------
of Dryers
.of -
Heaters 1CW
Hy4mmol Bathtubs
el -T_
Of Cell.-Sual (Paddle) Fam
-�f Hat
of On Bumer's
Of Gas Burners
of Air Cond,
KWArea Heatf ng XW
1CW
of Mata�rs Total HP
,,,I
n211'ency
ALARMS No.-ofZlmlft
o
beiv:DID
e 57
st mwxftg DwAtes .
oc,== 0 otbw
Esdmi&d Value of aclotdcaj
Work Or as PoWred by 7h—e
men 115� by ma&*aj poUcy.) . 11AWS06-r—of
Wwk to Staft IftP09dow W be reqwsted in accordar= with MEC Rule 10, and Upon CompletiolL
COVMUGE.- %hw waived by dbe owner, no Permft for the perforinmee of ejecaical work may issue unlew
the fiGmsee Punda proof of liability i.,,hdmg
certifies fiat sucb covamp - "W-pl-ad apel coverage or its m&UuIgal
Z g11,1M.and bas equivalent Tjw
OMIXONE: DGURANCE 0 =hUW PrOOf Of "Me to %e pell Wfi. office.
rj ,
I MWO, ws&r the palm andpmdda ofpayiV7 077MR 0 mpecify..)
Ow iftf
07=4&A on &,v 4
NUMNAMN.- 00. Ar A-wavdvpnWdft
or,
UC.N04
------- Wil—
qapplimb in
Addmss:
*Pcr M.G C. 147, 07-61, BM Tel. No.
AIL Tel. No. -
Public Safety f1s" Iicme.
OWNER'S INSURANCR WAMM- I Lic, NO.
Ucensft dow not iume fte U.Wyty - I -------
low, I hemby waive di. mmu=ce coverage normaRy
requitwi by law. BY MY Signal be 801 WOM *d the
2wnw/Agent the (check one f] owner owner's ag=L
Skusturi "ne
TelePhone No. ";tZFEE.- $t
�PBRWT
ELECTRICAL pEpjWT No.
INSPECTION REpORT:
ELECTRICAL ll?�SP_ECTOR - DOUG SMALL
1. ROUGH INSPECnON:
Passed - I I
Inspectors, comments:
- no Innials) - ---------- Date
1 1 FINAL lN.&PECn6N_.-
Passed - Vq Fafled- Re -in
Inspectorst Comm f
Af A
M. no (dais
Date
3. U"RR GROUND INSpWnON:
Passed - (j F*lW - Re4uspecuou Wred
!too)
10sPOCtOYS' comments:
- 110 infth) Date
4. INSPECTION — SERVICjg--
DATE CALLED NATTONAT, GRID. -
Passed — 1 —1 -- . Ffi"d Ro4uspection
inspectors I comments: Lm!t� �($",*) -
5. INSPECTION . oMIL.
Passed - I )_ Faffed - I I
Inspectow comments: _rw!!!d �(510.0�0_
-100
DOORTAGS ARE TOB.z ELLXp ---AND LMON SffZ IFTHE AREA ToBy
INSpF
'CTED IS NOT
ACCESSIBLE AND A RE-INSPF�MON OF &%00 18 TO