HomeMy WebLinkAboutMiscellaneous - 322 TURNPIKE STREET 4/30/2018N2 2 d u 0Date
..................................
O'`t. `ao ,a• 1
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that tt-....... C
/ .......... .....
has permission tG perform -�' p-�"'�
...........................
wiringin the building of ........................................................................
at ... ate ......:!..... ..c.... :.:a` ................... . North Andover, Mass.
Feed..:............. Lic. No.............................................................................
�a 7 ELECTRICAL INSPECTOR
12/21/98 11:19 15.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
Office 1.131 27
Ihi Liam IIuniuPIIlt of Permit No.
3 Beg2IiiII =1 of'PufAir —Aafztq occupancy A Fee Checked
BOARD OF FIRE PREVENTiON REGULAT10N8 527 CAR 1290 OM (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massacnusetts Electrical Cade, 527 CZAR 13:00
(PLEASE PRINT iN INK OR TYPE ALL INFORMATION) Date LU&
(Xji� or Town of NORTH ANDOVER To, the Inspector of Wires:
The udersigned applies for a permit to perform the electrtcai work described below.
Location (Street 3 Numb
Owner or Tenant
C,.vner's Address
Is this permit ;n ccnlunc:ien with a building permit:
P--:r--.-se ^f ,..aid;^
1. IE-xlsttng Siamcn Amos ! Vicits
Ne'.v Semite Amos
Nurncer ct=-------ors arc Amcac:,y
_..,.c,.,.,. arc Nat, --re _f . rc=csec E:ec-n-cat
Yes _ Na ' (C`eck Apprecnate Ecxl
Utility Autncnzation No.
Overi-eac Uncgrnc I, '- No. of Meters
Vclts Cverr.eac — Uncgmc •"_ No. of Meters
No. _f ranstcrr ..erS
No. _.yr...^.g cutlets �1c. �. =os KVA
Aoove— 'n•
No. :t "gr.t:r.g =:cures Swimming ?_aiKVA
crnc. _ Generators
No. of Emergency ugntim;
No. :t 1--ecec:zc:e Cutlets No. ::t Cil Surners ;
Satter., Units
No. at Switcn Cutlets No. at Gas=_rr.ers I
=iRE ALARMS No. at r.cnes
Total
No. at Cetecaon arc I
No. of Ranges No. at Air _are. ;ins I
Initiating Cavices !
iNo.ct +eat Tctai otai T
he. a �isCCsais r
?arcs Ons
No. et Stunting CCevices
Na. at Seit Cantainee
No. :.f r-1snwasners - ScaceiArea r4eanr.c �'� I
Oemc::cniScunc!ng devices
-NKW I
No. at _,ers eac:nc Cav:ces
I
_acai - Munictcal — Cthar
Cannec•:cn
No. at No. ar
I
t-aw Voltage
No. of •.vacer _eaters S€cr.s °allas:s
'n/ir.nc
No. :wct0 �1as5ace i:�s NO. of Mctcrs otai '+P
INSUSANCc 'C'/E=AGc ?•:rsuant :a the recuirements .-t Massacrusecs ;er.eral 'caws
_
1
I have a current L:datlity Insurance ?clic'/ 'nC:uC:ng Zzmc•eteC Cceraticns CJveraee or
is suostantial ect.'tvalent. YES NO _ I
nave suemirec vatic :riot at same :o cne Ct:ics. YES 9- NO = It you nave cr:ecxee YE„ crease ineicate :he r110e6caverage cy
cnecxing :ne aocrocriate cox.
A -e ,
/ 5
INSURANCE :X,SONO = O —1. ER = (Piease Sce �:±)
-
lacer
(Exetration
sitmatec Value of S:ethical Warx S
`+vcrx :a Star. Inscec::on Oa:a �acues:ec: Rcug^
Fnai �7
S;gnee uncer :he Penalties of ;ertury
�
30
FIRM NAME v l"LociC%%�.0
Jc. NO. 14S�
�S-
l.:censee S /�i lJs� -SSgr.acure
:C. NO.
Actress v� `�' �" " ✓r
Alt. .ef. No.
OWNE:i'S INSURANCc'NAIVER: I am aware that the licensee aces r+Ot nave the insurance
coverage or its sucstantiat eeuivalent as re-
cuireo ov .Massacnusetts Ganerat laws. ano :nat :may signature an In:s permit acCttcation waives !his reeuirement. Owner Agent
(Please cnecx one)
eiecrcne No.
PE."MIT
S erature ct Owner cr Agenti