HomeMy WebLinkAboutElectrical Permit #5170 - Permits #5170 - 129 COTUIT STREET 4/30/2004 ' 'lew�w�oa,�mMmG
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TOWN, OF NORTH ANDOVER
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�jillp INSPECTOR
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CIF Pcrmi,t N '"
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Occupancy a Fee C'l� l
A IRE PREVENTI I ' [Rev. 1 a 91
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APPLICATI LECTRiGAL RK
�" "" ' "� "'R ' "�` "' �� .w 1' D a t c:, �v ne
Cite or,Town, o d To the 1n; -of PP v-es
ion to perform,the e1ccrrical workdescribed below.
i t (Street & u ml r
Owner or Tennat Telephone O. � M
. t
Owner's Address
Is this m in conjunctiloti with n bu,11dinegy, rmi(? Y C5 N o (Clicck Appropriate Box)
Existliall Sarvice Arijr.s aits overlicad 0 Undord, . or t r
Nov S rvitc! Amps zeljl�" tLvuhs Overl'icadn r Na. ; t .
Number Feeders and, Anipacity
Location and NatureProposed Electrical, rl * z,:,L)
TOW
—FrI ro�,I's f o rmers KVA
No. arLighting Outlet, No. ur l-lot Tubs Generators KV
Above ,fin- INO.of hinergenEv LialrEin
No. or LichUna Fixtures Swimmina Pool n . Battery Units
o(Receptacle Outlets No.of 0*11 Burners FIPLE ALARMS IN'o. "Zones
ofDetectjoll and
�. w
.iN*o.of Sivitclies No.of Gas B u mersIm'd'atina Devices
i
1 . a a. No. r Tore
]No. Al� 1ces
Igloo
z 'Efl,
lli
No
� 1 ,�� l r s a A H tfr�a , KW Local �" r x t c a Other
Security Systems:
Healing Applinnclas
No,:orD,(!,v1ces1or Su
SJ!11 flat IDUtal or lilt
Teleco aaimunientx rt tt ilia:
No. orillotors Total, If P
No, Hydroniassage Bathtubs .of l) vices or t
t
OTHER:
INSUR " "E COVEIL E. ail i vc th �Mr r, r p r at r 11 rf r r l � gal � r�4 ��1 "Iess
sal
tile lick:nselc provid,cs proor orliability" an rli �l i11 , j '1 t t�r n"coveraute or its substandal ,ry al "t. 11
� 1 �certifies that 1 cover rce, n has exhibited r am t tli rat .issumv orri,ce.
CHECK ONE. INISURRANCE BOND
MM t:
hen required b municipal policy,.)
Estim,ated,Value of Electrical Work:
6L�� �I�� . 1 �� ��� � requested � � rti t�l, �1EC 1 lbw, �� u lti �
r, . �° air.� a rf1mrint)o r r ""r t r ,� .
1 10 a
Ll�"111 &,, - �� Ll C.N 0
F I 10,1 N i N I E 224,N.Z' :L.- � I
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N O.:
gy
(If " a j/, 1/rc liceive,cumber ne. Bus.Tel. No.,�P/
6LI1.1"z JL A A]t.Tel.N u.:.11"
Add ress: iat (lie Lictmse-m does irot Itave theliability insurance co%'era,(-P nogt�
rtr
law-'. �rSillnature below, 11 .waive this r i�r nicot, m the. 1-, c ti n r