HomeMy WebLinkAboutMiscellaneous - 90 MEETINGHOUSE ROAD 4/30/2018 (2)1110 I.tJLYI nuiv IIGFi& a n yr iyi i xlratti x2v u.i i o
BOAROOFFIREPRE'VFM ONREGUI MOM527C1 MlZW
Perndt No. �5
Occupancy & Fees Checked
APPLICATTONFOR PERMIT O ELECMCALWODIV
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ALL WORK TO BE PERFORMED IN ACCORDANCE THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat 411
Town of North Andover
The undersigned applies for a permit to perform the e
Location (Street & Number)
Owner or Tenant
Owner's Address Z l `�7
work described below.
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To the Inspector of Wires:
Is this permit in conjunction with a building permit: Yes [No (Check Appropriate Box)
Purpose of Building '� U P � 0,J Utility Authorization No. Z��
Existing Service Amps I Volts Overhead 1:3 Underground No. of Meters
New Service fps L1U[ Z. olts Overhead M Underground No. of Meters
Number of 1~eeders and Ampacity
Location and Nature of Proposed Electrical Work W v` [=
In
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers
Total
KVA
No. of Lighting Fixtures
Swimming Pool Above
[71Below
Generators
KVA
round
ground
No. of Receptacle Outlets
-Z1
No. of Oil Burners
No. of Emergency Lighting Battery Units
No. of Switch Outlet
No. of Gra 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
Heating Devices KW
Connections
ID
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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(Please check one) Owner a Agent
Signature Owner -or
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Telephone No. PERMIT FEE
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Official Use Only
Permit No. ,2,M
D� Sadctq Occupancy & Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK J
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—2-- & r
To the Inspector of'Nres:
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Numbery e_ 4,Fk- �,� ety- ;; v i e � j(tJ 1► �� O v t
Owner of
Owner's
Is this permit in conjunction with a building permit Yes a
Purpose of Building S ; p - vet,, t-, CD czl�_Vl
Existing Service Amps Volts
New Service Amps Voits
Number of Feeders and Ampacity
Location and Nature of Proposed` Electrical
No 0 (Check Appropriate Box)
Overhead 0
" T 1
Utility Authorization No.
Undgmd a No. of Meters
Undgrnd 0 No. of Meters
No. of Lighting Outlets
No. of Hot fuse
Total
No. of Transformers KVA
�1
Above a
in a
of Vghfing Fixtures
Swimmin Pool gmd a
gmd a
Gereeraiom KVA
No. of Receptacles Outlets
No. of Oil Bumers
NO -of Emergency Lightieg
Bat tery Units
No. of Switch Outlets
No of Gas Bumers
FIRE ALARMS No. of Zone
No. of Detection and
Initiating Devices
No. of Ranges
Total
No of Air Cord Tons
'
Total Total
DiposalHeat
No- Pumps
Tons
KW
No. of Sounding Devices
NoJ of Self Contained
DetectiondSounding Devices
Dishwashers
Space/Area Heating KW
Dors
Heating Devices
Municipal o Other
KWa
Local Connection
Water Heaters KW
No. of
S" res
No. of
Low Vokage.
Bailases
Wiring
ro a Tuds
No. of Malors
Total HP
9
E COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
urrent Liability Insurance Policy including Completed Operations Coverage or its substantial equiva Y = NO
valid proof of same to the NO N you have checked YES please in the type of cont age by checking the
CE BOND . OTHER 9 appropriate box.
- (Plea ify) � r` 5 U 2 o►v�. e.., Q r
Value of Electrical Work$ O O (Expiration Date)
art �%- !P . lj �'� Inspection Date Resquested Rough Final
der the Penalties rjury: ` _
w� ~ ~ e- LIC. NO.
1 e'L Signature
�_ LIC. NO...? 9S 7 3
Bus. Tel No. '7 t - Y 1r -yS-or
d -E It 0' Oh��A.1 O i Alt Tel. No. P 7 to"-
FAnd
CE WAIVER: 1 am aware that the Licensees hoes not have the insurance coverage or its sub tantiai egpivaient as required by Massachusetts
hat my signature on this permit application waives this requirement. Owner Agent (Please Check one)
Owner or Agent)
Telephone No. PERMIT FEE $
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