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Home My WebLink AboutWiring Permit - Permits #11975 - 83 COLGATE DRIVE 10/31/2013 Date ..... ............... °F pyORrN ?;. .•: .. °� TOWN OF NORTH ANDOVER PERMIT FOR MIRING CMU r This certifies that ..`..:.. � `.a. ...... ( L x:` has permission to perform x K wrong in the building of at ...... .�..`: . ..'. c., ... �' ..... ......... ,North Andover,Mass. j y Fee..... �...,.......Lic No. P �..`..,... t �..............i. .... .:.C.. .... ........ . ELECTRICAL INSPECTOR Check# — pP I� C l 11175 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 5- I Occupancy and Fee Checked 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 QaC),527 CNM 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: 1 U 3 0 13 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) I C es Owner or Tenant ��'-,�� v, , Telephone No. C_Tz Owner's Address S'!\,w.-� Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. _ Existing Service Ou Amps i 2 e o Volts Overhead 9 Undgrd❑ No.of Meters j New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: VC)<�e, Completion of thefollowing table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of Total /L`, Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.o mergency Lighting rnd. rnd. Battery Units _ No.of Receptacle Outlets 13 No.of Oil Burners FIRE ALARMS No. of Zones_ No.of Switches No.of Gas Burners No.of Detection and J . Initiating Devices No. of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No. of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: " "'"" " ' Detection/Alerting Devices No.of Dishwashers S ace/Area Heating KW Local❑ Municipal ❑ Other p g Connection No.of Dryers Heating Appliances gar SecN.o Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.H dromassa e Bathtubs No.of Motors Total HP Telecommunications Wiring: y g No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with NMC 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 exhi ited proof of same to the permit issuing office. CHECK ONE: INSURANCE [IBOND El OTHER ((Specify:) I certify, under thepains and penalties ofperjuiy,that the inforntation on this application is true and complete. FIRM NAME: f/}/e e`,*4" �ee-Avi c.,9 LIC.NO.:3I .5 D 2L. Licensee: Co jrj c; � j Signature s - LTC.NO.:^ �c- (If applicable,enter "exempt"in the license number line.){ �11 Bus.Tel.No.: Address: /�r� `/�'>r,.�' I '/ y ° � l"T[', I 6!a Xel Alt.Tel.No.: *Per M.G.L c. 147, s.57-61,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)Pi owner El owner's agent. Owner/Agent PERMIT FEE: $ Signature ®- Telephone No.-t AA 6�I.-ot,s ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§3L,the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, §32,an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall.be limited as to the time of ongoing construction activity,and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. ❑ Rule 8—Permit/Date Closed: ** Note:Reapply for new permit ❑ ❑Permit Extension Act—Permit/Date Closed: Trench Inspection Pass M Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass M Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: Pass Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: FINAL INSPECTION: Pass Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: DEB WEINHOLD ... TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com Division of Professional Licensure: License Search Page I of I The Official Website of the Office of Consumer Affairs and Business Regulation(OCABR) Division of Professional Licensure Mass.Gov Vlass.Gov Home State Agencies A-Z Topics Home)Division of Professional Licensure ONLINE SERVICES Check a License Check A, Pi-of.essional License Locate a Licensed Professional By the Division of Professional Licensure Online Address Change Contact the Agency . SEARCH CRITERIA More. . Profession:Electrician REFERENCES& License Number:31509 RELATED INFO NEW SEARCH Disclaimer Regarding LIC. LIC. LIC. Website License Searches BOARD LIC. TYPE NUMBER NAME CITY/STATE STATUS Enforcement Process Journeyman Glossary Electrician CONRAD J.ALECKNA MIDDLETON, Electricians 31509 Current JR. MA Glossary of License Status Codes Your search has resulted in 1 licenses More, The page above has been generated by the Division of Professional Licensure web server on Thursday,October 31,2013 at 8:36:57 AM. (D 2007-2011 Commonwealth of Massachusetts Site Policies Contact Us as http://license.reg.state.iiia.us/public/pubLicRange.asp?profession=Electrician&licenseNo... 10/31/2013