HomeMy WebLinkAboutWiring permit - Permits #12007 - 82 BERKELEY ROAD 11/18/2013 Date e .. ..............
NoRTH� TOWN OF N
ORTH ANDOVER
p5RMIT FOR WIRING
t A
88ACHug + ,
k` e �� S •.
���N
This certifies tat,... �.. , t
has permission to perform .. �w f t.
....
7
wiring in the building of ..... d er a
K
C, �C b
,N
North
�.... ..
CS Lt
a
at .....
_ t.. �¢:.
�.•... SPECTOR
� ( �9 I.1C.NO.�.���� �..� � ELECTRICAL Il`1
Fee....,.
Check# E x— -----
Clmm-onwea&ol YlIaMac4a6effi Official Use Only
Pen-nit No.
2epartment of Jim Servicei
Occupancy and Fee Checked
CL
BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 MR 12.00
(PLEASE PRINT IN INK OR TYPE ALL JNFJ0 TION) Date: F..2 Z 1. z)
To the Inspecto' of Wires:
City or hOWndOf:By this applicaonersigned gives notice of hi or her intention to perform the electrical work described below.
' e- t
Location(Street&Number) '
Owner or Tenant C�t,,7ec 41 *1 I A' Telephone No.
Owner's Address cl Yn-e-
Is this permit in conjunction with a building permit? Yes 0 No �J) (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead El Undgrd ❑ No.of Meters
New Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical _U Work: <4,A—�'k-s's
J L/
Completion of the.following table may be waived by the Inspector
No. f Total
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tr o Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above F-1 In- 71 of Emergency Lighting
grnd. grnd. " Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo. of Zones
No.of Detectionand
No.of Switches No.of Gas Burners Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons
No. of Waste Disposers Heat Pump . ..........J..K.W........... No.of Self-Con ned
Totals: I Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local El Municipal El Other
Connection
Security Systems:
No.of Dryers Heating Appliances KW No.of=Zs ces:or Equivalent
No.of Water KW No.of No.or— Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No. H ydromassage Bathtubs No. of Motors Total HP Telecommunications Wir!-n :
No.of Devices or Equivalent Ile
,,5
OTHER: 4,
Attach additional detail if desired, or as required by the Inspector of Wires. �2
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: �7 Inspections to be requested in accordance with MEC Rule 10,and upon completion. ,14'
INSURANCE CO ERAGE: 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 F-1 BOND F OTHER Fj (Specify:)
I certify,under the pains and penalties ofp that the information on this application is true and complete.
FIRM NAME: LIC.NO.: FA
:L-1,11 r,
Licensee:(11 r b4v Lik?i, J, Signature LIC.NO.:
(Ifapplicable,'enter in the licell e number line.) Bus. Tel. No.:
Address: i"ar"-kll,04- Alt. Tel. No.: Yi� 7;7
*Per M.G.L. c. 147,s. 57-6 1,security work requires Department of Public Safety"S"License: Lic.No. . :-
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)F-1 owner El owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $
393,Jcri('ho Tpk ) i 6
Mincola IVY I150I
05/24/2015
0