HomeMy WebLinkAboutMiscellaneous - 730 MASSACHUSETTS AVENUE 4/30/2018O
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Date .................�8��-C�
NORTM
°f`"`°:',"� TOWN,OF NORTH ANDOVER
= p PERMIT FOR WIRING
This certifies that
A)t � bo�v �
......................................................... �'��.............
has permission to perform .sn U < <'.......'
wiring in the building of ......... ........................:...................
at ... !J D........ ¢l.S S� ... North Andover, Mass.
kFee... ............... Lic. NOA.IY....q.l................ . J 2 �
2 ELECTRICAL INSPECTOR
. Check # ✓��
7930
J
Commonwealth of Massachusetts Official Use Only
Department of Fire Services Permit No. / 40
Occupancy and Fee Checked
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 (MEC), 527 CMR 1 .00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Z Z
City or Town of: NORTH ANDOVER 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) % . � A/Q.55 4 c �11SPA A V e
Owner or Tenant fA rCL(, Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No V4— (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts
New Service `WO Amps 0 / 7-'40 Volts
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
: vl S ( ( !U"C, , ("', —o, - t
Overhead ❑ Undgrd ❑ No. of Meters
Overhead ❑ Undgrd K�l No. of Meters
-FEE Ib_ LIE- Servl'(
('o !e!i-" n/'fl— In 11....1:,... -M- .... . L_ _ _� L I I _ • _
No. of Recessed Luminaires
-
No. of Ceil: Susp. (Paddle) Fans
�crvu/vcuu L/tCl//J ec/uru rreres.
No. of Total
Transformers KVA
No. of Luminaire Outlets
No. of Hot Tubs
Generators KVA
No. of Luminaires
Swimming Pool Above ❑ In- Elo.
rnd. rnd.
o Emergency ig ng i
Batte Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Devices
No. of Ranges
TotInitiatin
No. of Air Cond. Tons
No. of Alerting Devices
No. of Waste Disposers
Heat Pump
Totals:
Number
Tons
" "
"KW
'-' """"""' '
No. of e - ontained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Municipal ❑ Other
Connection
No. of Dryers
No. o Water
Heaters KW
Heating Appliances KW
No. of No. of
Signs Ballasts
Security Systems:*
No. of Devices or Equivalent
Data Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications W irmg:
No. of Devices or E uivalent
OTHER: LakcLC-e— l V�
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: 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
the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE -BOND ❑ OTHER ❑ (Specify:)
I certify, under the pains andpenalties of perjury, that the information on this application is true and complete.
FIRM NAME: q /^OCOh ���>^/ C qt LIC. NO.: Ad 6
Licensee: c' t p11.e' 71 NG Signature LIC. NO.:INt 6c7t (
(If applicable, enter "exempt" in the license numbgr line.) Bus. Tel. No.. � - u " Z 7d 7
Address: _(O® W�>R�L��.St64- -<-Ik Alt. Tel.No.: S'%- d
*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: $ `j