HomeMy WebLinkAboutMiscellaneous - 68 GLENNCREST DRIVE 4/30/2018 68 GLENNCREST DRIVE
2101104.0 0061 0000.0
N2 2 124 Date....................
Of
%ORTII
TOWN OF NORTH ANDOVER
0
6 ' % PERMIT FOR WIRING
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This certifies that .........0.......F...=. ........ .......
. . .............I.....................
has permission to perform .......
wiring in the building of....1.[.,
dir
-/..... ............... .................
at.... ..... ......................... .North Andover,Mass.
Fee....` A Lic.Noll
................................................................
ELECTRICAL INSPECrOR
-711/013/98 09:18
15.00
PAID
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
i
Office Use Ors—
Permit
nto / p,
r V�E• e. ic
Permit No. O�Etputmtttt oftq Occupancy 3 Fee Chocked
BOARD OF FIRE PREVENTION REGULATIONS 527 C.11112:00 3190 peeve blank)
: M APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massacnusetts Electrical Code, 527 CMR 12:00
(PLEASE PRINT IN INK 0 -
R TYPE ALL INFORMATION).. N 0
RMATIONOate
QM or Town of NORTH ANDOVER To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number)
, . Owner or Tenant
Owner's Address `e
? ' Is this permit in conjunction with a building permit: Yes _ No (Check Appropriate Box)
Purccse of Building ro t !/jam / Ile J-
Utility Autnonzation No.
Existing Service _U d Amos Vcits Overr•,eaa -:�Unagrna No. of Meters
New SarAce Amps / %itsCverreac _ Uncg:no No. of Meters
Numoer of Feeders ana Ampacity
Lecaucn ana Nature of Prccosea Elec:ncal :Ycrx /.✓, �- �'l{
No. of t.•gnting Outlets octal
KVA No. pct 'as i No. of ranatormera KVA
i r
:
No. of Lighting Fixturta I/ g 'oi Swimmin Above- :n• —
� grna. _ Srric. _ I Generators KVA
! I No. Of c!nergency Ughting
Na, of Recectac!e Outlets I No. at Cil Burners sarery units
INO. Of Switc 1 Outlets Na. at Gas :urners I FIRE ALARMS NO. of Zones
No. of Ranges I7Vo. a! Air Cr.C.
nota: No. of _etection ana
tons Initiating cevices
No. of Oisoosais I No.ar Neat Tota: -ota:
?ur..as Tons K%V No. cf Scunaing Owices Y
No. of.Sa�f Containea i
No. of Dianwasners - I SoacerArsa Hearing �v 0e:ec:0niSounaing Oevices
No. at Dryers Heanng Cevices KW tccai -' Municioai •-Other I
Connec::on
NO. at 140. ai Law Pottage
Ji No. Of Water Heaters KV'I I Signs Sailasa Wir:ng
No. 4voro Massage Tubs I No. of Ltatcrs Total l,P I
O HEa: i
INSURANCE CCVEAAGE: Pursuant:o the requirements at %iassacr_sers ;enerw taws i
1 have a current lia0iiity Insurance Pour/ ins:using Car
a:eiec aticns Caverage or :is suovantial scuivatent. YES 1
have suomineo vatic ;roof of same to the Office. YES - O = It ycu nave cnecxea a. atease inoicaa :ne
YE' type at coverage cy
Checxing the aoproon��a e-oox� _ _ s
INSURANCE S--30N0 _ OTHER _ tP!ease aaec:yl j
Esnmatea value of E!ec:ncai Want S
IExotrauon Oatei
�nJ work ;O Stan' // " ';';' Insoecaon Date Aacues:ac: Roug❑ ���� - ��Final
Signed en-41O&Z"
r:he Pee�na:ttes of perjury:
FIRM NME /�' - ^"// ��
UC. NO. 3
License �- ? S;g-at%;reUC. NO. y 3 '
Aoaress •� f� 4 716-
3ua. Tet. No.
vi t f Z All. el. :Jo.
OWNEA'S INSURANCE WAIVER: I am aware !hat I'M* L:cenaee Does no nave me insurance coverage or its 3u0stantial sauivatent as re-
aturea by Massacnusetts General Laws. and that my signature on :.`.is aermn aoPimation waives this materement. Owner A m
(P!ease cnecit ones /� ��,
ISignatun of Owner w Aqn^i+ aieonons ,40. PEAMIT F£, s U
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