HomeMy WebLinkAboutMiscellaneous - 7 Putman Road BUILDING FILE
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�' °t,"`° '•�"° TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
US
This certifies that r . J L L
.........................^................. ................................................
has permission to perform "�ly/Z.V.-..A
wiring in the building oft" o,, S r7 ......................................
at........ .. U.� �? ... ..T................. .North Andover,Mass.
� Fee..................... LIc.No... .. ............... ..,r..... .... .............
F ELECTRICAL INSPECTOR I
Check #
r
5630
�� (.onvxonuraa�of���a�ar!'uc�all, For Office Use Only
(Rev.11/99)Permit NNumber.mbs ^^ / 3-D
�UsParfAuwr�a`�s��� rE?
BOARD OF FIRE PREVENTION REGULA/IN' OCC°�"`��'Fee
APPLICATION FOR PE ERFORM• ELECTRICAL WORK
(ALL WORK TO BE PERFORMED TFIE SETS ELECTRICAL CODE 5I7 CMR 1200)
PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date:
i
City or Town of: To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below,
Location: (Street&Number) T—
Owner or Tenant: ('z/, v f Loi s -7_
Owner's Address: 2 -31
Is this permit in conjunction with a Building Permit? Yes s---No o (Check Appropriate Box)
Purpose of Building: 'o i c �_/j �/
Utility Authorzaton#:
Existin9 Service: a Amps/z
Volts Overhead Underground.❑, #of Meters
New Servicer. Amps / Volts Overhead ❑ Underground.[]9 #of Meters:
Number of Feeders and Ampacity:
Location and Nature of Proposed Electrical Work:
No.of Recessed Fixtures No,of Cell.•Susp.(Paddle)Fens No. of Transformers
Total KVA
No.Of Lighting Outlets No, of Hot Tubs
Generators KVA
No. of Lighting Fixtures Swimming Pool: Above ground o In Ground ❑ #of Emergency Lighting Battery Units
No,of Receptacle Outlets f No. of 011 Burners U Fire Alarms #of zones
#of Detection&Initiating Devices
No.of Switches No.of Gas Burners #of Sounding Devices:
#of Self Contained
No,of Ranges No, of Air ConditionersTOTAL TONS: Detection/Sounding Devices
Local❑ Municipal Connection a Other ❑
No. of Waste Disposals Heat Pump Totals:
No.
of
Number. TONS: KW: Ntty Systems:
No.of Devices or Equivalent
No.of Dishwashers Space/Area Heating: KW
Data Wring,No.of Devices or Equivalent:
' No.of Dryers _ Heating Appliances KW
Telecommunications Wiring:No of Devices or
Equivalent:
No. of Water Heaters KW No. of Signs: #of Ballasts:
OTHER;
#of Hydro Massage Tubs
No. of Motors Total HP
INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance
including'completed operation'coverage or Its substantial equivaie . The undersigned certifies that such coverage is In force,and has exhibited proof of same to the permit
Issuing office, CHECK ONE: INSURANCE c,+!� BOND ❑
OTHER ❑ Please specify:
Estimated Value of Electrical Work (When required by municipal policy)
Work to Start: Insections to be
1 MEC Rule
cerdly,under the pains and penalties of perjury,that the Pn ormation on thissted applicationdance is true tm compiotet0,and upon completion.
Firm Name: �
LIC.#
Licensee: / 5,.,� // Signature:
(if applicable,enter a Yin the license nyrn line) LIC. 33
4 Address:
' 9us.Tel.#��� 'Z Gyr Alt.Tel.#
®WNER'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
vmive this requirement. I am the(check one) Owner❑ OR Agent o
Signature of Owner/Agent:
Telephone#
PERIMT FEE:S