HomeMy WebLinkAboutElectrical Permit #5836 - Permits #5836 - 230 JOHNSON STREET 6/10/2005 Commonwealth of Massachusetts offiei e only
Department of Fire Services Permit No.
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BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. 11/99] 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: 6-10-05
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) 230 JOHNSON STREET
Owner or Tenant RANDALL LILLY Tclephone No. 978-689-0549
Owner's Address SAME
Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box)
Purpose of Building RESIDENCE Utility Authorization No. t
Existing Service 200 Amps 120/240 Volts Overhead M Undgrd❑ No.of Meters l
New Service 200 Amps 120/240 Volts Overhead❑ Undgrd ® No.of Meters I
Number of Feeders and Ampacity 3-4/0AL 205A
Location and Nature of Proposed Electrical Work: CHANGE FROM OVERHEAD TO SIPHON FEED
No.of Total--
No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans Transformers KVA
No.of Lighting Outlets No.of Hot Tubs Generators KVA
A grnove n- o.o Emerge i mg
No, of Lighting Fixtures Swimming Pool d ❑ nd. Batte Units
No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.a Detection an
No.of Switches No.of Gas Burners Initiating Devices
No.of Ranges No.of Air Cond. Torts No.of Alerting Devices
No. of Waste Disposers Heat Pump um er Tons KW No.o Self-Contained
p Totals: ................................................... ....................... Detection/Alertin Devices
Munic
No.of Dishwashers Space/Area Heating KW Local ❑ 'PP' Other
Connection
Dryers Heating Appliances KW Security Systems:
No.of Dic
ry N D
o.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or E uivalent
No.Hydro massage Bathtubs No.of Motors Total HP Telecommunications Device Equivalent
y g No.of Devices or E uivalent
OTHER:REFEED TELEPHONE&CALE TV
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licen-
see provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certi-
fies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE M BOND ❑ OTHER ❑ (Specify :) (Expiration Date)
Estimated Value of Electrical Work:$2,500.00 (When required by municipal policy.)
Work to Start: 6-8-05 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
I certify, under the pains and penalties of perjury, that the information on this application is true and complete.
IRM NAME: WILLIAM J.IANNAZZI,INC. LIC.NO.: 13592A
j.Xensee: WILLIAM J.IANNAZZI Signature LIC.NO.: 13592A
Bus.Tel.No. 978-686-7300
ddress: 191 CHANDLER ROAD ANDOVER MA 01810 Alt.Tel.No.:
WNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normally required by law.
y my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent.
wner/Agent oature Telephone No. PERMIT FEE; $ � —`�''
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