HomeMy WebLinkAboutMiscellaneous - 72 SAW MILL ROAD 4/30/2018The Commonwealth of Massachusetts °"`" Use O'` 7
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Department of Public Safety S
Occupancy S Fee blank)
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 3/90
(leavee blank)
APPLICATIONl moork (°FORm�PERMIT TOrdance with PERFORM alELECTRICA7 CIR L WORK
(PLEASE PRINT IN INK OR TYP •ALL•INFORHATION) Date 19 V
City or Town of� C�6DVCCTo the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described belo:►.
Location (Street & Number) oCircuit # _o)l
Owner or Tenant _ D A)
I a o A- I I 0
Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No ® (Check Appropriate Box)
Purpose of Building Utility Authorization 140.
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 LOW VOLTAGE ALARM SYSTEM
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers Total
KVA
No. of Lighting Fixtures
Swimming Pool Above In-
grnd. ❑ grnd. ❑
Generators KVA
No. of Receptacle Outlets
No. of Oil Burners
Battef Emergency Lighting
nits
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS No. of Zonis
No. of Detection and "
Initiating Devices '--'
No. of Sounding Devices
No. of Self Contained
Detection/Sounding Devices
Local ElConnection []Other
Connection
No. of Ran es
g
Total
No. of Air Cond. tons
No. of Disposals
No, of Heat Total Total
s Tons KW
No. of Dishwashers
Space/Area Heating KW
No. of Dryers
Heating Devices KW
No. of Water Heaters
No. of
SigLolar nsf Ballasts
Wiirinoltag CarduAccess Fire
No. Hydro Massage Tubs
No. of Motors Total HP
OTHER:
AR 1 9
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws -
I have a current Liabilit Insurance Policy including Completed Operations Coverage or its substantial
equivalent. YES ® NO [] I have submitted valid proof of same to this office. YES ❑ NO ❑
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE X❑ BOND ❑ OTHER ❑ (Please Specify) Royal Insurance Company 10/08/95
I Expiration ate
Estimated Value ,o Electrical Work S `
Work to Start L4 19SInspection Date Requested: Rough Final R
Signed under the penalties of perjury:
FIRII tIAKE Security Systems, Inc. d/b/a Sentry Prolective Systems LIC. N0. 1109 C
Licensee_ James W. Lees Signature /V 11
tIC. NO. 000080 Public
Address_ 310 Florence Streetr Malden, MA 0214 Bus. Tel. No. 617-38g-9700 a ety)
Alt. Tel. No. EOO-445-4505
OWNER'S.IRSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub-
stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit
APPlica.tion waives this requirement. Owner Agent (please check one)
Telephone No.
- :Signature of Owner or Agent
PERMIT FEE � ffLD
7, TO 2227
� 3
Date ....... 4-111 7A
TOWN OF NORTH ANDOVER Q
d
PERMIT FOR WIRING o
0
AL
This certifies that ........ S -P-0.. r' ........1../c'^vl Pc f �!.'P..... ....�
has permission to perform ........S-C..G............ J.. .S./P....'! . .................�
wiring in the building of
at .......)..; G �...1...c�. l m)... ,*' tA..... �.�............. . North Andover, Mass.
Fee... 3—�.. �.. Lic. No.././*(..76..............................................................
ELECTRICAL INSPECTOR
P� ���"73100,
WHITE: Applicant
CANARY: Building Dept. PINK: Treasurer GOLD: File