HomeMy WebLinkAboutMiscellaneous - 33 Huckleberry Lanei
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Date.....,....,,,...., ..... ....
°`<«`°;•,"o TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
This certifies that .... ....... �.PC /i/'(.r.u..(...........
has permission to perform ..... (.a......./ q� K..C.`................................
wiring in the building of .... .. ` r' . /C., ..! . ..... U F'. v ...................
at ..!:-d�?........ ..%..... �.!. �`.�� y....... , North Andover, Mass.
..............................................................
ELECTRICAL INSPECTOR
C (1 0 A 17 f� 46124198 09:13 ZOO, 00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
Office Use
fs4,4S
tEeQWL6�U�,404_,6�Oc cup ricy & Fee Checked —
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:06
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
pJ1work-to be pedarmed in aca:ordance with the Massachusetts Electrical Code 527 CMR 12:00
(ply Print in ink or type all information)
Date 6 a�? y - i `6
To the Inspector Of Wires:
To"of North Andover
for a to perform the electrical work described below.
The undersigned applies permit
Location (Street & Numbeer��-
�V e 314
Owner or Tenant
�,
N a -U t tL
d U
d + i
Owners Address
Is this permit in conlunctran with a building permit Yes
No ❑
(Check Aate Sex)
ppr�ri
No. (� 7
t
Purpose of Buildi S a,
Utility Authorization
Undgmd- ❑ No. of Meters
fps_ Volts
Overhead ❑
Existing Service
No. of Meters
Amps /ZdJZ U Voits
4—OverheadQ.
Undgmd
service
Number of Feeders and AmpacitY
Location and Nature of. Proposed Elec tncal Work
Total
No of-Transformers-KVA
Na. of Hot fuse
No. of Li h n Outlets
- Above Q to B.
Pool and ❑ ❑
.Generators 1NA
No. of Uqhtinq Fixtures Swimmin
No. of Flnergency Ughting
Units -
No. of Receptacles Outlets No. of Oil Burners
FIRE ALARMS No. of Zone
No.of Gas Somers
No. of Swtcp Outlets
Tota
No. of-Detecton-and.
No of Air Cond
Tons
Initiating Devices ---- �—
No. of Ra es ).feat
Total
Tons
Total
KW No. of SoundingDevices
No. Pum s
Na. of Di
Noi of Self Contained
KW OetectionlSounding Devices �--- ---
Heati
B Municipal ❑ Other
OTHER:
INSURANCE COVERAGE Pursuant to the regia ed Operations
e�ous� s�� Or its substantial equival Y = NO = nye box
I have a.current Liability Insurance Policy inciudi NO if you have -checked YES.ptease indicate the coverage try checking the apProP
have i valid proof of same to the Office
IN = BOND = OTHER = (PI Specify) (Expiration Data)
ated value of Electrical Work$ Irtapectlon Date Resquested Rough / , �� ('ice(/ Final
Work to start
Signed under the Penalties of -penury:. UC. NO. `--^
FIRM NAME
LIC. NO.
�, Signature
Licensee
Bus. Tel No.
Alt TeL No. -- achusetts
Address
OWNER'S INSURANCE W t am a are that the Licenses dogs not have the ement. O coverage or iffi se beta nt atequivalent k One) required Y
General Laws. And that my- signature an this permit application waives this requirement Owner Ag
Telanhnnn No.
PERMIT $�