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Home My WebLink AboutMiscellaneous - 27 YOUNG ROAD 4/30/2018i N2 Date.. 11-0 ... TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ............................................................................................. has permission to perform ........ I .......... .......... :..n ...... ........... wiring in the building of ....... e . 1-4-'-, ................... ............................ ............. .. ....... at ...... z.. ........... North Andover, Mass. Fee..................... Lic. No.. ....................................................................... 7 — - ELEcTRicAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ottt�e U." a,,y The Commonwealth of Massachusetts Permit 3o. Department of Public Safety 130ARD OF FIRE PREVENTION REGULATIONS S27 CMR 12:00 °" 1'an[y a Fee a blank) -`-! 3 / 90 ♦ cleave- blank) -APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the MauaChUfetts Electrical Codc. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE AU INFORMATION) Date Clty or Tow -4 of '�JG, To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 22-------------- 1 Owner or TenantC' rv�or—, Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization NO. Existing Service Amps / Volts overhead ❑ rd Und ❑ g No. of Meters New Service Amps /_ Volts Overhead ❑ Undgrd ❑ No, of Meters Number of Feeders and Ampacity `--- Location and Nature of Proposed Electrical Work No, of Lighting Outlets No. of Not Tubs No. of Transformers Total No, of Lighting Fixtures Above ❑ In- KVA Swimming Pool grnd, grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. cf Emergency Lighting No. of Switch outlets Battery Units Pio. of Gas Burners FIRE ALARMS No. of Zones No, of Ranges No. of Air Cond. Total tons No. of Detection and No. of DisposalInitiating Devices Disposals Heat of HeatTotal Total Fumps Tons^ KW No. of Sounding Devices No. of Dishwashers Space/Area Heating Kia No. of Self Contained y Detection/Sounding Devices No. of Dryers Heating Devices KWMunicipal Local ❑ -- — Connection ❑ Other No. of Water Heaters KW llo, of No. o Signs Ballasts Low Voltage Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: n( l 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 ❑ NO ❑ I have submitted valid proof of same to this office. ❑ If you have checked YES, please indicate the YES El NO type of coverage by checking the appropriate box. INSURANCE N BOND ❑ OTHER ❑ (Please Specify) Estimated Value of Electrical Work S "--/Y) — Expiration Date Work to Start _ Inspection Date Required: Rough g Final Signed under the penalties of perjury: FIRM NAt AMERICAN ALARM & Q01 -M -11 -BW LIC. NO. 1 7 1 2r Licensee_ TrgARl1 T --SAMPSONSignature / Address 7 CENTRAL STREET LIC. N0. ARLINGTON MA 02476 Bus. Tel. No.)R1 _641 _200D OWNER'S INSURANCE. WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner. Agent (Please check one) Telephone No. J y C ) ` Signature of Owner or Agenr. PERMIT FEE 'S Date.......(!. fv(J �NOKT 1 ° ,``° '• "� TOWN OF NORTH ANDOVER Mesita,p PERMIT FOR WIRING This certifies that ...... ..r..S.E' . a............ �. ........� has permission to perform ............................................. wiring in the building of ........�✓..G%�11 %C1 % .! L ................................................... at .........T... ..... (..v. `'..`.�. ..... G..( ..:................. .North Andover,,Mifss. Fee ...: Lic. No ...............y.�f..... /'LGCMICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer y C.ommonwoa[� o` l �as9ac�caet� cc77 1JaparInwd o`.}i a Serviced UV BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. _ 0 3) Occupancy and Fee Checked Rev. 11199]. tte,vP 1,1„,�, APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachuscus Electrical Code (MEC), 527 CMR 12.00 (PLE,ISE PRINT IN INK OR TYPE,ILL I1WOR:b1:17101V) Date:�al —� City or Town of: N• A 21 Vtjyf' To the Inspector of Wires: By this application the undersigned gives notice of ltd or her intention to perform the electrical work described below. Location (S(reet & Number) Owner or Tenant Owner's Address Telephone No. Is this permit in conjunction with a building permit' Yes ❑ Nokn (Check Appropriate Box) Purpose of Building ��$/ P�1,-6 Jitilily Authorization No. Existing Service Amps / Voits Overhead ❑ Undgrd ❑ No. of lIeters New Service Amps / Volts Overlicad ❑ Undgrd ❑ No. of Meters.. Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: r•..,...1.1;- ,.r.,.,. r-11 .... :_ .._L, No. of Recessed Fixtures --••• •-•••••• ••. •••� •.••v..mC No. orcein: Susp. (Paddle) Felts .ewer III UC 1 vlvea ov me nnsR cctor of hires. ! °• °Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In ❑ rnd. end. o. o mergericy ig t ing Batte6 Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARDIS No. of Zones No. of Switches No. of Gas Burners i o. o etection an Devices No. of Ranges TotInitiatin No. of Air Cond. / Tons No. of Alerting Devices No. of Waste Disposers 1• eat Pump Totals: tm I uer _R.R 1 __ t o. o c - ontaine DetectioidAlertinE Devices No. of Disliivashers Space/Area Heating K`VLocal ❑mulimpal ❑ Other Connection No. of Dryers No. of Water KW Heaters Heating Appliances KWSecurity o. o i o. of Signs' Ballasts ystems: No. of Devices or Equivalent Data Wiring: ' No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP 1 e ecomniunicahons iring: No. of Devices or Equivalent OTHER: Attach additional derail if desired, or as required by the Inspector of Wires. 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 cove a is in force, and has e:d9bited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ 0"I'IIER ❑ (Specify:) —On Estimated Value of Electrical Work:' (When required by municipal policy.) (Expiration Date) Work to Start: - I certifj•, un (ter MUNI NAME. Licensee: (If applicable, enter Address: OWNER'S INS required by law. Owner/Agent Sigtiatur• Inspections to be requested in accordance with MEC Rule 10, and upon completion. and penalties oper'ugth((at !!tr irrjornration au this application is true and complete: -S i /nnu�- to-L66L4 to-L66CO LIC. NO.: 4 /2)q � Signature LIC. NO.: 6 3q � " in a l'cence i iie. 1 flus. Tel. No.- Alt. Tel. No.: JRANCE WAIVER: I am aware that the Lice a does Piot have the liability insurance coverage normally By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Telephone No. FPj_--RJ11TrE-E-: $ J