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HomeMy WebLinkAboutMiscellaneous - 98 BEVERLY STREET 4/30/2018 (2)N_ OW o m O m co m o < bM o m o m 1 o c f Date.......Z- Z- ©19 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......... 14 ..... 4 ............................................................................. has permission to perform ........ ...................... e :.............................................. (f 40 1-7.0wiring in the building of ......................................... .................. at ...........................................5.........--- ......................... Fee .fir.--�� .... Lic. No elf;,Clld�Ll) . .............. ....... . LECTRICALINSPECTQR Check # rA �— eQ � Official Use Only m~nwea k or /?/1r assac em Permit No. F 714 1Jeparfinen� o�,}ire �ervice6 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC). 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: -' /1- O City or Town of: ,ot.?�er,% 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 & Owner or Tenant Owner's Address T U Rte' % 2 71 09S'3 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Boa) Purpose of Building Utility Authorization No. Existing Service Amps / _Volts Overhead ❑ Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work::v 5 lcl.lia_ cart U%cu��" (�S7LdeY/ Completion of thefollowing toble may be waived by the Inspector of f ,fres. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans of . Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ rnd. rnd. o. o mergency Lighting Batter Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of, Switches No. of Gas Burners No. IDetection and nitiating Devices In No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices Heat Pum number Tons K.W No. of Self -Contained No. of Waste Disposers p Totals: ��� � ...................................................... Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Sec�otof Deterns or E uivalent No. of Water KW No. of No. of Data Wiring: HeatersSigns Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs N'o. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: DO Atacli odditionol detoi' if desired, oras required by the /»speclor of Illires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspec...ms to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE CONIER GE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completzdoperation" 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, tinder the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: /4� / /� i/ LIC. NO.: Licensee: Ae fe ler'Ce Signatur LIC. NO.: 02 (If app licoble, enter "exempt" in the license number line.) r Bus. Tel. No.aOU .137� Address: /' CIL /'✓jid� �� %�i5, Vhf Alt. Tel. No.: *Per M.G.L.. 57-61, security work requires Department of Public Safety "S'° License: Lic. No. S5CG1yoa 577 OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage nonnally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agen . Owner/Agent r Signature Telephone No. __ _I PERMIT FEE: '� Y � ££ZL-b4£ (888) :2f31N30 IIVO 33b'S 910 / iauoissiwwoo 6b0£0 HN 'SMOH 210 NO1NIl0 8 L 30831d M 2jnHibV S301Ab33.11;bn03S lad :asuao11•S r 0-ZSL :ou •jl OLOZ/OE/SO,:sandx3 LL3000 00 SS; :-ia9wnN aouejea10;O aIe)ywa0 -L01/IS/L0 Q hZol 9I92-OL6I0 VW W31VS i. 1S WVHdn I 338318 M 8nHIHV Oi ?Sw30;1 SI>-tl S3nSSI - N IOINH331 W31S kS (M131SPD3�1 _ SN diOid1O3i3 30 S-U.3snH3VSSIVW 20 Hllb'3MNOWWOO r. •