HomeMy WebLinkAboutMiscellaneous - 691 WAVERLY ROAD 4/30/2018i
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This certifies that ...............................................................
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has permission to perform ....... !° Gt1 0
..........................................................
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wiringin the building of..................................................................................
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ke .... ......... Lic. No. 2.g ..Un
ELECTRICAL( INSPECTOR
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TBE COMMONGVEUTHOFMASSACHUSETTS Office Use only
DEPARTA1W0FPUBLICS4FE7Y Permit No. 4,;
BOARDOFFIREPREVEMONREGUL HONS527CMRl200
Occupancy & Fees Checked
APPLICATTONFOR PERMIT TO PERFORM ELECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street �
Owner or Tenant
Owner's Address
Is this permit in conjunction with a building permit: Yes Q No Q� (Check Appropriate Box)
Purpose of Building / .y Aeln Utility Authorization No.
Existing Service Amps�Volts Overhead M Underground
New Service .200_ Amps Z0/ ZVoVolts Overhead Underground
Number of Feeders and Ampacity 3—
Location
^
Location and Nature of Proposed Electrical Work
No. of Meters
No. of Meters
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers
Total
EVA
No. of Lighting Fixtures
Swimming Pool Above
Below
Generators
KVA
round
ED
ground
No. of Receptacle Outlets
No. of Oil Burners
No. of Emergency Lighting Battery Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS
No. of zones
No. of Ranges
No. of Air Cond. Total
Tons
No. of Detection and
No. of Disposals
No. of Heat Total Total
Pumps
Tons
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
Local Municipal
Other
No. of Dryers
rY
Heating Devices KW
Connections
No. of Water Heaters KW
No. of No. of
Signs
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HP
OTHER
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and that my signahue on this permit application waives this Iequilelr>ent
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Telephone No. PERMIT FEE $
Igna re o caner or gen
Crawford & Company
1001 Summit Blvd
Atlanta, GA 30319
Phone 877-346-0300
5/19/2015
Inspector of Buildings
1600 Osgood Street
North Andover, MA 01845
Re: Insured:
Claim Number:
Policy Number:
Our File:
Date of Loss:
Type of Loss:
Location of Loss:
To Whom It May Concern:
David Correlle
033580098
22052400004
6776-2610006
2/20/2015
Weight of Ice & Snow
691 Waverly Rd
North Andover, MA 01845
A claim has been made through Arbella Mutual Insurance Company which involves loss, damage, or destruction
of the above captioned property, which may either exceed $1,000 or cause Massachusetts General Laws, Chapter
143, Section 6, to be applicable.
If any notice under Massachusetts General Law, Chapter 139, Section 3B is appropriate, please direct it to the
attention of the writer. Kindly include a reference to the captioned insured, location, date of loss and claim number.
Very truly yours,
James Warren
Crawford & Company
CC: City/Town Fire Dept, City/Town Health Dept