HomeMy WebLinkAboutMiscellaneous - 34 EAST WATER STREET 4/30/2018 (2)N° 2599
Date . ................................
°,t"'° '• '"a TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
This certifies that
................................ �......:'.�f�........ !...........
has permission to perform - - {,
wiring in the building of f� . �`..............................`f
.............. .. .....:........
at ........................ ;�rthtAkndover, Mass.
Feer............ Lic. . ..............�:: .. ......................................
ELECTRICAL INSPECTOR
Check #t
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
Official Use Only
Permit No. t�4t5��9
D�� S
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy & Fee Checked
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00
(Please Print in ink or type all information)
Date 1.'—' LL—Oca
To the Inspector of Wires:
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number J q 3 (�e 3 a— - l 2 ,
Owner or Tenant�` tk (_JCT-
Owner's
T- � (
Owner's Address ^� �E ES l�U` ' _ A(- A-0 F r—
MVS- oz( -3 C'
Is this permit in conjunction with a building ermit Yes ❑ No ®' (Check Appropriate ox)
!-16=4t-11-46— 1-0 RE64r- OP--
Purpose of Building Utility Authorization No.
Existing Service Amps Voits Overhead ❑
New Service Amps Voits Overhead ❑
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
Undgrnd ❑
Undgrnd ❑
No. of Lighting Outlets No. of Hot fuse I oral
No of Transformers KVA
Above ❑ In ❑
No. of Lighting Fixtures Swimming Pool grnd ❑grnd ❑ Generators I(VA
No. of Receptacles Outlets No. of Emergency Lighting
p No. of Oil Burners o_ .. ,._.._
No. of Switch Outlets I No of
No. of
No of Air Cond
Tons
Heat Total
Tota
No.
Pumps . Tons
KW
Space/Area Heatino
KW
Heating Devices
KW
No. of
No. of
- 1`70. Hydro Massage Tuds I No. of Motors TntnI up
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial eqt
7URCE
valid proof of same to the Office YES= NO = If you have checked ,Y�E�S, Please indicate
INBOND = OTHER = (Please Specify) /tYC�/Z
cL
se of Electrical Work$ ���
Work to Start Inspection Date Resquested
Signed under thties gf eer'u /-
FIRM NAME
FIRE ALARMS No. of Zone
No. of Detection and
Initiating Devices
No. of Meters
No. of Meters
No. of Sounding Devices
No./ of Self Contained
Detection/Sounding Devices
❑ Municipal ❑ Other
Local Connection
Low Voltaae
rale YE NO =
Ie type o Covera a by checking the appropriate box.
— Q
Expiration Date)
LIC. NO.//7� S-
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Zip
-� LIC. NO. ! �S^�O
?� L %�C / ` /�` �Z 7 Bus. Tel Na. cOf t Z -O — �"
Address Alt Tel. No. lam! Gr 2 -r• p �-0
OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or Its substantial 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. PERMITTEE��
(Signature of Owner or Agent)
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