HomeMy WebLinkAboutWiring Permit - Permits #8294 - 111 CHRISTIAN WAY 8/12/2008 °:Date.... .:. ' .. . `:.
e HORTH
° "o TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
°, s'+
S3 CHUS
b�
This certifies that `�� ��" "g . ..... .. .
has permission to perform .....
wiring in the building of. :.- ....L .........
at .............. ....... . %.... ..,North Andover,Mass,
u
Fee..,:.. ............ Lic. No. .... ........ ... .�, � .. ...
...
ELECTRICAL INSPECTdi
Check #i 1f b'
PtmnitNo.
..Uapa ts,a�t o�.t�w.Sr*.w oc=panoy and Pee Chakcd
BOARD OF FIRE PREVENTION REGULATIONS .Iron
APPLICATION FOR PERMIT TO PERFORM �aa�O
R�
na week to be paftWd jn Wwdpmwii fke .
^WE PRIM I NN,[WX OR 7Tp' ALL Iri�'D
Qty or oxen oiFAhl TO the Inspector Of Wb""
�' or bar imaiwas io perform the ekctiieat work doaaibod below.
Uy des* eatlM the undersigned gives notice of his Or
Loeatioli(sued&Number) jj
Owner or')t'enant ° . .' .
TelepboneNo
Owner's Address
fie conjanatian with a btdkVng part' Yet El No ❑ (Check Aplirupprlitla Hoe)
)i ."pew UtWty Amthorkatlen No.
Purpose ofRm6ding
Rttlsftg Setdm Amps / Vale Overhead❑ Undrd❑ No.of Noun
Teel -. Amps /Volts Overbead❑ Undgrd❑ Na S(Meters
Number of Feeders and AnpWitY
Locxom of 1rr+opoaed=W*leml Work: r ec' 't Y 4 e ✓` C"
and Nstnre" "
ion the tabta be waived by the I if'W1res.
No.of C,sO.SoW.(Paddle)Fans o.
of 1 TOM
Na,of Recessed Luminabros T ers OVA •::
No.or Lmn lumen Outlets Na or Ptea Tabs Getaeextt�ors
>ti~VA
,-.:--
Kneirm
Na of Ianminab^ea swlmmm�JPoa e Q -d. ❑ U cY g
No.of ReeMbdo ORtlefs No.of Oil Banner's .,° ALARMS N&ofZORN
No.,of Switaka Na of Gee feturnaeapow
No.of Rtsages No.of Air Comd. T rixw w Akr'tlnp Uimlcfs
a�as o.of mWevskilk"
N'q.of Wrist Uleposars DefftftWAkrd=DOV-1—m
No.of D18bVmd6oWrs SpacdA rat Sehttng RCW Laati❑calmummkoeddm 0 oibir
lReating AppUssees 3CW '
No.of Dr Y Pia ar:
a o ater o.o a 'Daft W1r btg:
8epters S " Na of Davlow or
No.IlydromammW Bathtubs No.of Motors TOW Hp Ift of'DevAeee or`
OTHRR:
" .leach add dmd 4Wratl fds bid or as ngr4+adby dw bupow r 4rWires-
E timated Value of
Wor1C c; (When required by muniaW policy.)
Wane tr start C ~ ." hopecti ons to be requesW in amordance witb MSC RWe 10,and upon t ormletion.
MSURA.NCR COVERAGE.. Unless waived by the owaer.no pczmk for do porkwomince of electrical work amy issue unloos
the licerme providon proof of liability insurance meludmg"ao Vhftd operation"coverage or Its subsmMW equivalent. The
CHECK rasa nastl r�►Nc� at�rm 0 El (p,�y:) IC J, is1,im$office.:2
I canft under 1/ie fable miwt of perjury►tl�rer the o>r dktaAt ftm and ionqrle�e.
PH M NAMR: ' ' "t UC.NO.:
�}w�,�,��"��/�u nble.dater anan�at rn the luxrrue nsnabes line) tatrre Bns.Tel.N.. 1 - ,
�caneee. Sf�t "l C 7
Address: ," "l F Alt.Teti,Nep:
*Par M.G.L.a.147,a.57-61,sa:urity work requires Depmgammt of Public Safety"S"Lim Lis Nn.
OV MWS INSURANCE WAIVER: I am aware that the Licensee does not haws the iiabflity insureneo�normally
required by law. BY my signature below.I hereby waive this mquireumt i am the(ch:ad�c c�xta owner ❑owner's a m!e
Siipa��t Telephone No.