HomeMy WebLinkAboutFire Dept Permit - Permits - 9/6/2012 JUG-6-2002 17:08 FROM:NORTH ANDOUER FIRE 9786889594 TO:815088655441 P:2/2
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APPLICATION ,FOR PERMIT
/ y DIG SAFE NUMBER
City or Town /cry
Date
Start Date.
n accordance with the Provisio
n
s of M.G.L. Chapter 148, as provided i,n Section application is hereby made
)Y P�\ t J t�� l J+�l- S .
U" I l C�ci11L-LPL C.� G d°�t., L
(Fall name o(person,-Firm orcorpvratlon)
address r) C7
' ('Sweet orP,o•8oz)(City rTosvn)
or permission to (state clearly purpose for which permit is requested) - V I
sme,cf competent operator(If Applicable) - ,� Gera. No_ to
° I
ate Issued-rejected G
(signature clApplicartl)
ite of expiration r I ' Fee 15.() r QQ $ Paid Due
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PER
MI
or Tawny DIG SAFE PIUMBER
Start Date:
mit Number (if applicable) =_j
ccordance with the provisions of M.G_L_ Chapter 148, as provided In this permit is granted
'� � - (FvAn?rne of person,Finn orCorporatiarl) /
9/7
1
Frictions: -
(Give location by,Ve t and no,,or describe fn such manner as to providc adequate!o 61,2V
�� olloca(ion) .
Paid $
'— This P _rmi� will ex�ire on L/100n Lr,2✓nZ-04Tioir j
ature of�Oficial G rar Ling Pe Title fi? ��/��
IS TERED MASTERL CT ICI
ISSUES THE ABOVE LICENSE TO:
RE,NAUD, ELECTRIC & COMMUAIC
THDMAS` H RENAUD
18 P OVIDENCE RD
BUTTON! MA 01590-381`3
17459`,:1A 07/31/13 03672 .
Division of Professional Licensure: License Search Page
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Name:JAMES H. EBBELING Locate a Licensed
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"This Licensee has additional Licenses click here to view them."* Contact the Agency
Licensing Board: ELECTRICIANS
MASTER ELECTRICIAN REFERENCES&
License Type: TYPE CLASS: A RELATER INFO
License Number: 12271 Disclaimer Regarding
Status: CURRENT Website License Searches
Expiration Date: 7/31/2013 Enforcement Process
Glossary
Issue Date: 5/23/1988
Exam Date: 4/9/1988 Help on License Search
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This web site displays disciplinary actions dating back to 1993.
This license has had no disciplinary actions taken during this time.
o _
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http://license.reg.state.ma.us/public/pubLicenseQ.asp?board_code=EL&type_class=_A&li... 8/17/2010
09-13-'12 11:20 FROM-Renaud Electric 5088656844 T-465 P0003/0003 F-952
Commonwealth of Massachusetts Official Use Only
Department of Fire Services Permit No,
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank X
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEQ,527 CMR 12.00
(PLEASE PRINT X INK OR TYPE ALL XFORM4 TION) Date: -L-142 Job# Z6306
City oar Towoof: m6akg 014oVF_(L- 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) 100 ALdovuL L4 FA15
owner or Tenant U
.. I A&) rn Telephone No. 99 7 f2.4 e,
Owner's Address 100 PS 0r1e>Nu:_t1__
Is this permit in conjunction with a building permit? Yes No X0 (Check Appropriate Box)
Purpose of Building 0 e E I ez� A� L_ Utility Authorization No.
Existing Service NA Amps I volts Overhead F1 Undgrd 7 No.of Meters
New Service NA _ Amps I Volts Overhead F] Undgrd ❑ No.of Meters
Number of Feeders and Ampacity NA
Location and Nature of Proposed Electrical Work- _gLtoav�I k c t--N -Lb t ev
L A
CoMlefion qfthefibllowingtable inav be waiM Y the Ins eator of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Vans No of-- Tota
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Nf Einergeucy Lht
No.of Luminaires Swimming Pool ove grnd. 0 In-
rl_n d. Bette o.o ry Units ig ing
No.of Receptacle Outlets No.of Oil Burners, FIRE ALARMS No,of Zones
No.of Switches No.of Gas Burners N etection and
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerti® Devices
Tons
No.of Waste Disposers Tre—al-N—MUp Number Tams Fro-79F=0 - oit—aimcd
Totals: , *.................... ............ Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Localn Municipal 0 Other
Connection
No.of Dryers Heating Appliances KW Security S stews:1V
No.of 4evices or Equivalent
No.of No.of Data Wiring:
0:1�1 .11 tzrt e star
Signs _...Ballasts No.of Devices or E4uivaleftt
No.Hydromassage Bathtubs No.of Motors Total ffp Telecommunications Wir!,n
No.of Devices or Equiv 5ent
IOTHER:
Attach additional detail if desired,or as required by the hispector of Wires.
Estimated Value of Electrical Work: _,5-6rM (When required by municipal policy.)
Work to Start: Vi/I a ...- I Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE 00MERAGE! 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 s4ch coverage is in force,and has exhibited proof of same to the pen-nit issuing office,
CMECIC ON-E., I'NSURANCE N BOND [I OTRER E] (Specify:)
I certify,under the pains and penalties ofterjury,that the information on this application h true and complete.
FIRM NAME: Renaud Electric&Communications Inc. LIC,NO.; A-17459
Licensee:Thomas Renaud Siguatur LIC.NO.: 'E-24023
<A~g�PA , -
(1fapplicable.enter "exempt"in the license number line.) Bus.Tel.No.: 508�865j130k_
Address; 18 Providegge,Road Po Box 36 Sutton M,4.01590 -865-3513
Alt.Tel.No.: 508
Per M.G.L.c 147,s 57-61,security work requires Department of Public Safety'IS"Liceo8e Lie 4
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 EJ owner 0 owner's apent.
owner/Agent
Signature .Telephone No. [PE�j17T7 r,EE: $