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Miscellaneous - 69 OAKES DRIVE 4/30/2018 (2)
69 OAKES DRIVE 210/107.A-01 43-0000.0 Date... .r::. :n.G...... NORT" �: -•.;. Q� TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSACMUS� This certifies that ....... :.................. has permission to perform.`:`.`:.... -.... c-... . - ,,<.. �!............. e wiringin the building of.::................................................................................ ,. .... ,North Andover,Mass. tz /6iar� Fee.. n.:. ..... Llc.No�-:......... . t:. ELECTRICAL INSPE R i Check # � 8320 Commonwealth of Massachusetts Official UseOnly p Department of Fire Services Permit No. ,, o� Occupancy and Fee Checked 99— BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(NEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Ataou s-� �8, �Ooa City or Town of. NORTH ANDOVER To the InspecYor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 0 06-6-iCS D k j k Owner or Tenant (2kRI S Telephone No. Owner's Address -GAM e Is this permit in conjunction with a building permit? Yes ❑ No Ef (Check Appropriate Box) J Purpose of Building r P g / �GJ�3Q Utility Authorization No. , 5 Existing Service 10 0 Amps 2 0 /A40 olts Overhead ® Undgrd❑ No.of Meters New Service 00 Amps lad IA40 Volts Overhead© Undgrd ❑ No.of Meters Number of Feeders and Ampacity RZ,01AC e1 STI l j OJ 1Cr+?p f6yo�gMrp�, //�/Cn e4S;c Location and Nature of Proposed Electrical Work: �ll �ul 7Q j (�J/IZ C 12UrI7 p si (20h1f&0/ VAAif I. Completion of the.following table may be waived by the Inspector Of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ n- ❑ X-5—.51 Emergency Lighting rnd. nd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of Detection and No.of Switches No.of Gas Burners No.Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers eat Pump nmper ons JNW o.of elf-Contained Totals: Detection/Alerting Devices ' Municipal No.of Dishwashers Space/Area Heating KW Local El Connection ❑ Other No.of Dryers Heating Appliances KW SecuritySystems:* No.of Devices or Equivalent No.of Water K`,1, No.o No.o Data Wiring: Heaters Si s Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP % Telecommunications firing: 1Z.# No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start:LV;// CA II Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless Z the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE N1 BOND ❑ OTHER ❑ (Specify:) I certify,under thepains andpenalties ofperjury,that the information on this application is true and complete" FIRM NAME: i d W 4aki LIC.NO.: /a Licensee: SAM e Signature _A,4 ✓ �v LIC.NO.: (If applicable,enter"exempt"in the license number line.) / Bus.Tel.No.• r 'd :i Address: 4 MtJ/4EyZ � 1V-C Y � V �� C-7L6 1960 �� Alt.Tel.No.: g *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ 0 e� �� II r , I S&P r c, 4 I t, r M