HomeMy WebLinkAboutMiscellaneous - 540 Turnpike Street N° 2 o7 Date...Z�/v`..
NORT►{
;� r°;,;�``°;•�"°°� TOWN OF NORTH ANDOVER
o
PERMIT FOR WIRING
11 slow
,SSACMUSEt pp
O
1 y�j
I This certifies that .. 1. 15'.C&t!. ..t.4�.S ..�... AJAKM...........
has permission to perform ...�// .[.a z?..0.1......... j�/_S �! '�..................
wiring in the building of.......,(> s
at..... ... !� /••�a.E?..r.. ,../4............................ .North Andover,Mass
Fee... Lic.No./....[..... ,......................................................
ELBCTRICALINSPECTOR
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
IEN,�OR =4' 0 N OF-"-N. ANDOVER 001923 CONTROL NUMBER IS 27063
VOICE INVOICE DISCOUNT NET INVOICE INVOICE DISCOUNT NET
LIMBER DATE AMOUNT AMOUNT NUMBER DATE AMOUNT ALWILINT
101598 10--15-98 35. 00
INSTANT SIGNAL&ALARM CO.,Inc. THIS CHECK 1 LA I L'-!'-4 VOUCHER NO.
_!!��PAYMENT OF ITEMS LISTED
"N -+f 0!tice Use Only
The Commonwealth of Massachusetts
•„ Henle Xo.
Department of Public Safety
U%f Occupancy A Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS S27� MR 1200 3/90 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed In accordance with the Mauachusetu Electrical Code, $27 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
City or Town of /(/ an UC' V - {- To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street b Number) 7 y� _ ..y r .�i J S i(,�• �T !/i;ylt
Y
Owner or Tenant A:7 //
t/
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 ❑ Undgrd❑ 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 Total
g 8 No, of Hot Tubs No. of Transformers EVA
i
No. of Lighting Fixtures Swimming Pool Above In-
grnd. ❑grnd. ❑ Generators RVA
No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting
i Battery Units
No, of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones
No. of Ranges No. of Air Cond, Total No. of Detection and
tons Initiating Devices
No. of Disposals No. of HPumps eatTotal Total No. of Soundin Devices
Tons KW g
No. of Dishwashers Space/Area Heating KW No. of Selg Contained
Detection Sounding Devices
No. of Dryers Heating Devices KW Local❑ Municipal ❑Other
Connectio
M No. bf Water Heaters Sig sf Ballasts No. of WirLow ng Voltage il /
No. Hydro Massage Tubs No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current Li�it Insurance Policy including Completed Operations Coverage or it ubstantial
equivalent. YES Q NO[] I have submitted valid proof of same to this office. YES NO
If you have chec d YES, please indicate the type of coverage by checking the appropriate. box.
INSURANCE Er BOND ❑ OTHER❑ (Please Specify)
Estimated Value of Electrical Work $ (Expirationate
Work to Start ,1e' o Inspection Date Requested: Rough Final
Signed -u-Aer the peva ties of perjury: / 7
FIRM NAME Zjt,/S �n S r SN W f7 LIC..N0. //(1 7 L
Licensee���� ( �� LL. Signature LIC. NO: %7
Address Bus. Tel, No. 7�'ISIS/- l0 7D
Alt. Tel.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or t9. sub-
stantial equivalent as required by Massachusetts Generalws, an that my signature on this it
application waives this requirement. Owner Agent (Please check one) 1���
Telephone No. PERMIT FEE $ V
Signature of Owner or Agent
° `�
s
y
4
FROM Panasonic FAX SYSTEM PHONE NO. Feb. 23 1998 03:29PM P1
t�
'. ............. ry � ' . . ..... , tr '1'?£• is�'2•; .. .;e#,,...: .<�:'�•.`.x::.:..;:<.i•.....::t, ;";•w};e., :. ."Toi�DR4NC`" ? F : AL ?AKs • » h
! VY Y
.............. ""''•
Z."•"_.
I PRODVCEA HIS CERTIFICATE IS ISSUED-AS A MATTER OF INFORMATION
I ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
' HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
: A.B.K. INSURANCE AGENCY, INC. ALTER THE COVERAGE AFFORDED 8Y THE POLICIES BELOW.
133 CENTENNIAL DR ___._COMPA IlASAFFORDINGCOVERAGE
I PEABODY, M.A. 01960 ' COMPANY
.(978) 531-655.0--.—EAX.: .53.1-9.442 A, EMPIRE INDEMNITY COMPANY
INSURED ; COMPANY w• --
INSTANT SIGNAL & ALARM CO. , INC. '•, 8 SAFETY INSURANCE
305 HIGHLAND AVENUE COMPANY
SALEM,MA 01970 C EASTERN CASUALTY
COMPANY
D ,
`cy:6..•>fwfrraca�0.r• ;R' ta`.;r,yA.N k �7;»+.i `�,: 'T:ILIW4,Y'Iilt... .xy.; `r,> ' .1, Iy;.Y ''•..�,e'"f;3'i` .S-`,trttir ,jtr,}-1'.•y'i. � .. .
f COVERAG•�$:#fi;�.:.'s:�?;��'J�s;.��?"ki�'"'.c.- u!4'�'•?h'b'�S s'.�':E�;�::aYcs�Rd�r�';W1��L�. '',ii'�'�:�x",v1 '"yswrnla:�'t�;:s=f?A;fm;'iti ��','b���t� :�F.`.,�s.�'s�"r.:«l�;t'l�..i�,,, '''k�,;
T►+iS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
I INDICATED,NOTWITHSTANDING ANY REOUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
j CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I COI POLICY EFFECTIVE i POLICY EXPIRATION I S
ITR TYPE OF INSURANCE I POLICY NUMBER j DATE(MM/DD/YY) DATE(MM/DOlYY) ; LI►IITg
i :GENERAL UABIIm f ':GENERAL AGGAEGATE S ► I
4r•COMMERCIAL GENE>�IABIUTY PRODUCTS-COMP/OP AG_G S ►
• _ CLAIMS MADE I OCCUR! ; I •PERSONAL i ADV INJURY •6
A_OW�NjEER/S�i&CONTRACTOR'S PROT; IN ISSUE 01/01/98 i OlI01/g9 ;,EAC!+
I .y.•�iC3l-WiW�lIi,YJJ,�........w I I 'FIRE DAMAGE JAAy"s Oro ;S5
", ••i
1141 S S i ONS TUC MED EXP aX one person)
( AUTOMOBILE LIABILITY
A I ANY AUTO M j ; COMBINED SINGLE LIMIT s 1, Poo, 000
I I ' ,.
ALL OWNED AUTOS BODILY INJURY
_ SCHEOULED AVTOS' 1 ;(Per Deport) S
i $_ HIRED AUTOS 1500029 ` 01/01./98{ 01/01/99
8000.Y INJURY S
NON-OWNED AUTOS (Per eaident)
j .
-� — PROPERTY DAMAGE 3
GARAGE LtABILiTY AUTO ONLY•EA ACCIDENT
I ,ANY AUTO OTHER THAN AUTO ONLY!
EACH ACCIDENT 1 S
t
I AGORE13ATE i5
Iw••Y EXCESS LIABILITY I j 'EACH OCCURRENCE ,9 ^•
UMBRELLA FORM I .AGGREGATE IS
_ OTWr.A THAN UMBRELLA FORM
WORKERS COMPENSATION AND i ' WC STATU• DTH.s; ,
EMFLOYERS'AlABILtTY
i ^El.EACH ACCIDENT :6 5 0 0, 0 0 0 —
THE PROPRIETOR! �'-I
I ``PARTNERSlEXECUTrvE !—�WCL IN ISSUE j 01/01/9 8i 01/01/9 9 EL DISEASE-POLICY LIMIT �S 5001 000
I OFFICERS ARE: EXCL' _ ( El DISEASE•EA EMPLOYEE °S 500, 000
^OTHER I I I t
j I I
1 .
i DESCRIPTION OF OPERATIONS/LOCATIONSNEHI"ZWSPECIAL ITEMS
ALARMS AND ALARM SYSTEMS—INSTAT,LATIONS, SALES, SERVICE REPAIR AND MONITORINGI
INCLUDING CCTV ,SPRINKLER/FLOW METER; INDUSTRIAL PROCESSES SYSTEMS
iCEoff _ ......... ..... ... . . _. ' ...... . . . . ,,0 ,�•-�,+~, ..- us:::,,. ;,s,nab''A:��l»C�+ 'ht�f#`S�T•i9<i-3�-%•>Fu-`.{ ��
.N ..;-.;: :':;_, �: .sill h �- � , ^ •.
i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 0EFORE THE
I EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL !
DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT.
I
i BUT FAILURfi TO MAIL MUCH NOTICE SHALL IMPOSE NO OBLIGATION O0.LIABILITY '
OF ANY KIND UPON THE COMPAIJY. ITS AGENTS OR E►RESENTATtVEB. 1
AUTHO EED REPRESENT VE j
i• , — 'ir+ ....�.. •4Y •A '.I( *G ,rse•....,a •/�r:•.e •!,'•wy.:.,•....n..—.,•:..:.v.
ACORD S. 1Jyr :�.C&'1!! .e � I
ufihJ�ui .v