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9934 1 Date....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ......................................................... ....... .......... ..
has permission to perform
wiring in the building of ....
at..5e ...................................................... ......... orthAndovei, Mass.
Fee ... ............... Lic. No.. 73 7,-?
.......... ................. * ....... A ......................
ELECTRICAL INSPEc-r6,
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Commonwea& o f Hadlock detl4
2.par1m.ent of Jim Serviced
BOARD OF FIRE PREVENTION REGULATIONS
Official Use Only
Permit No. �% 7/
Occupancy and Fee Checked
[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: March 3, 2011
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) 50 Royal CreSt DriVe Building # l
Owner or Tenant Royal Crest Apartments Telephone No. 978-681-1822
Owner's Address 50 Royal Crest Drive North Andover, MA 01845
Is this permit in conjunction with a building permit? Yes ❑ No X❑ (Check Appropriate Box)
Purpose of Building Commercial - Apartment Building Utility Authorization No.
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: Install 6 Gell Packs!
Comolelion ofthe followinn table may he waived by the Invneclor nfKrec
No. of Recessed Luminaires
No. of Ceil.-Susp. (Paddle) Fans
No. 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
Battery Units 6
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Initiating Devices
No. of Ranges
No. of Air Cond. Total
Tons
No. of Alerting Deviccs
g
No. of Waste Disposers
Heat Pump
Totals:
I.Nu%b,er
Tons
J.KW
No. of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Municipal ❑ Other
Connection
No. of Dryers
Heating Appliances Kit
Security Systems:*
No. of Devices or Equivalent
No. of Water
Heaters KW
No. of No. of
Signs Ballasts
Data Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications Wiring:
No. of Devices or Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: $ 600.0Q (When required by municipal policy.)
Work to Start: 03/03/2011 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 and penalties of perjury, that the information on this application is true and complete.
FIRM NAME: The Electricians & Co. Inc. LIC. NO.: A10737
Licensee: Michael J. Parziale Signature LIC. NO.: E20269
(If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 781-322-9344
Address: 50 Branch Street Malden, MA 02148 Alt. Tel. No.: 781-322-3100
*Per M.C.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. SS CO 001021
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 a ent.
Owner/Agent PERMIT FEE. $ 125.00
Signature Telephone No.