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HomeMy WebLinkAboutMiscellaneous - 826 OSGOOD STREET 4/30/201800, o 2 m —o b cn 600 0 0 cn 0 o c-ni C) o m o -� Lo !on cat NO. f Date TOWN OF NORTH ANDOVER poi�& te of Occupancy $ Building/I 4)fe �rit Fee $ C" Fou6ldaoor) Permi $ OPer Perm $ ti F gg ion ee $ Water ConneRIIOZZE� $ '0 C) 4_4 TOTAL $ U Buildirig-Inspector Div. 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L p CL C ii h•� uai o C9 LA. CD 7 m m E � ^ W _z oV) > LL, V, �X W c� .vC� � ca O 00 _ O N d z O V) W __.I ZD J MR O z h .E a 4 L a -o y� r � c w O d u a E c n. o O c C u z •— CL O w c o ao V � O z N2 Date ...... &ORTH TOWN OF NORTH ANDOVER 0 I PERMIT FOR WIRING This certifies that ...... ....... has permission to perform . ........ .......... wiring in the building of ....... ............................. at .... ........................ ...... . ....... .... Li '�/ . < . ................ North Andover, Mass. ................ c. No. . .. ............ *E� *C' A**L"I* N**S'P'*E* C**T'O'* R**' * * ... *"**'**** 07/30/98 08:51 75-00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Rough Service Final Z 014r TDIIUii1QAt ralt4 of Mussar4twens Office Use only NiQ11 %0 Department of Public Safety Permit No. BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy & Fee Checked /sL 3/90 fleave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date /��/ 7g City or Town of ��tJ>,A ' / % nUiwPl' To the Inspector of Wires) The undersigned• applies for a permit to perform the electric/al work described below. Location (Street & Number) Owner or Tenant U� [ (� P G r ha/�/ I Owner's Address Is this permit in conjunction with as /building permit: Yes No (Check Appropriate Box) Purpose of Building '/ Q [ ° (ham Utility Authorization No. �m �1 ` 3 12�f Existing Service ©� Amps _L�J-2Volts Overhead 0 Undgrd ❑ No. of Meters It New Service SD Amps l a �� Volts Overhead LJ Undgrd ❑ No. of Meters Number of Feeders and Ampactty l ✓ 3Vg top, c Location and Nature of Proposed Electrical Work � ��� SPf'V4,-70 t,, na,./i,c�P 3 ]Le>/ -N C p ,i �. r OTHER INSURANCE COVERAGE: Pursuant to the requirements of Massachusttes General Laws �� I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES 211 0 O ! have submitted valid proof of same to this office. YES VNO IJ If you have checked. YES, please indicate the type of coverage by checking the appropriate box. INSURANCE LJ BOND ❑ OTHER❑ (Please Specify) Estimated Value of 7Electrical Work $ Work to Start ��/� g Inspection Date Requested: Rough Final (Expiration Date) Sig Ned under the penalties of perjury: FIRM NAME �.14" J�eNAe-. +� �PC�r'Cc1 ( ( LIC. NO. �r Licensee 10411 a )4-AR24 Signature `�-� -- /�"�� LIC. NO. -3 Address 3 /h, , Xe f '-)f Ad— ^r fio ear" /h 14" A / 3 Bus. Tel. No. C178'� FS a' LOZs�� Alt. Tel. No. Q 9 9 -1�1- 3 �$ ✓r'� er OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by M;sachusetts Genera! Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) i Telephone No. PERMIT FEE S fSicnature of Owner or Agent) TOTAL No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA Above In - No. of Lighting Fixtures Swimming Pool gmd. ❑ rnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battea Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and °ta No. of Ranges No. of Air Conditioners Tons Initiating Devices of Sounding Devices Heat Total TotalNo. No. of Disposals No. of Pumps Tons KW No. of Self Contained Detection/Sounding Devices No. of Dishwashers Space/Area Heating KW Municipal ❑Other Local❑• Connection No. of Dryers Heating Devices KW No. ot No. of Low Voltage ;No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massae Tubs No. of Motors Total HP OTHER INSURANCE COVERAGE: Pursuant to the requirements of Massachusttes General Laws �� I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES 211 0 O ! have submitted valid proof of same to this office. YES VNO IJ If you have checked. YES, please indicate the type of coverage by checking the appropriate box. INSURANCE LJ BOND ❑ OTHER❑ (Please Specify) Estimated Value of 7Electrical Work $ Work to Start ��/� g Inspection Date Requested: Rough Final (Expiration Date) Sig Ned under the penalties of perjury: FIRM NAME �.14" J�eNAe-. +� �PC�r'Cc1 ( ( LIC. NO. �r Licensee 10411 a )4-AR24 Signature `�-� -- /�"�� LIC. NO. -3 Address 3 /h, , Xe f '-)f Ad— ^r fio ear" /h 14" A / 3 Bus. Tel. No. C178'� FS a' LOZs�� Alt. Tel. No. Q 9 9 -1�1- 3 �$ ✓r'� er OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by M;sachusetts Genera! Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) i Telephone No. PERMIT FEE S fSicnature of Owner or Agent)