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HomeMy WebLinkAboutWire Permit - Permits #12470-01 - 25 CEDAR LANE 7/9/2015 C anu>cotzwaaLf�i a rl�dacltrr�ot�i official usa Only t1�TAtP1t7CD7F1 a�.,,J'IPD�/1TUICIJ.j Pemut No. BOARD OF FIRE PREV):WON REGULATIONS Occupancy and Fee Checked [Rev.]lll7] 0,avablank) APPLICATION FOR PERMIT TO PERFORM EL.ECTRICAL, I All work to be perf'arrned to eccordance tvilh ilia Ma,sachusetts Elecuicni Cad C),5?7 CMR 12.oo (FLF-4&E FRL?VT 1ArM L7 PE .INFtJMIMTIOM 'Date: !° City or TtaSvri of: To the 1 s ector Of ft-Lv : IIy this application the undersigned gives notice ofhls or her intention tD perfarrn the electrical work described br .Location (Street&Number) Owner or Tenant Telephone No- Owner's Address ~--- Is this permit in canjunetian IVitli rx buildingper-mit? yesL43 Na ❑ (CherlcAppropY-intel3 Purpose ofSuilding 1UtilityAuthoriantion No. Existing Service Amps / 1laIts Overbead ❑ Undgrd❑ No. of NIaters New Service Amps / Volts Ovr±rhend C] Undgrd ❑ No. of Meters Number ofTierders and Ampacity, Location and Nature of Proposed Irlcetricfii'tyarlc: am Ietlan ol'tlra/ollaTvin male rrra}�be ivaiyred L r rho No.of Recessed Luminaires Na.of CGZ.-Susp.(Paddle}funs T`fo.of �t Transformers No. afLurninaire Outlets No.of Not Tubs Generators Ic Na.afLutnInaires Slvirriming PDaI .A.bovc An- o.o ,mergency rg tn� end. � read. ❑ Bane Units r No. ofReceptncle.Outlets No.of Oil Burners FIRE ALARNfS No. off No.of Switches No.of Gas Burners o.of Detection an Initiating Devices No. ofItanges No.ofA.ir Cand. Too 'Pons Na.ot Alerting Devices No. ofWastcDisposers catPurnp mmn r ans LNo.ot elf- ontatnea Totals: Detection/Aiertin Devices No. of`Disbivashers Space/Area I?enting ZCW Local❑ Munic pa COnnCCUDOL No. or Dryers Venting Appliances lNV Security Systerns: D.ai<1 aicr No.of l7evicrs or uiv Na. of No. of Renters IC�V Si ns Ballasts Datallo.of evices or--f I uiv No.Tlydromnssage Bathtubs No.orMotors Tatnl HP Telecorarannicntions Wirir. No.ofDevicas or r my OTHER: Attach additlotrnt detail ifdes1re4 or as required by tlre.Insp Estimated Value of Electrical Work (When required by municipal policy.) It-work to Star[: Inspections to be requested in accordance with MEC Rule 10,and upon carnpie INSURANCG-COV. -R:A. :=Unless tivaived-6y-the ozvner�•n'o=permit=fat�fihe=p�rfa munhe n€ele'ctitcal Wi�rk may the licensee provides proof ol•liabll* insurance including`completed operation"coverage or its substantial•equiv undersigned certifies thatsuchcoverUdis In farce,and has exhibited proof ofs e t Thep it issmn o�{ce_ CHECE:ONE• INK RANCE BOND © OTHER ❑ ( perffy.) E`eerci Jr srttt fi z�r=fll pit pural>'1es a paijxt---Mat-i l }tirrrio�irf� i�r"rtrtfatr Lc to i' gyp, _. / PP Irr�1l I t tivl NAIirLl: t✓ -/ i C LTC.No.-/J Licensee: r ,- ?y C,✓ Signature _ _ LIC.N0.; (fapPlicable Add ry' rrpt"in refirensenunrberline `'� ��—Rus.TrJ_Na. ressr < /�' dr �v�C' c� AIt:Tel.Na.: Per M.t31.c. ]d ,s.57 6I,security work requires L}epartrnent of'Public Safety"S"License: Lie.No requ R'S bNSURANGC�VAIVIJR: I arty swore that the Licensee does nol have the Ifability insurance ccoverag required by law. By mysignalure 6elaw,I hereby waive this requirement I am the(check one)❑owner C wner/Agent Signature Telephone No. PER1l4T"f=PrE � �' Wfth o \M � . e....., ...,..N KIM Date........ . ...., MEN g ff owm oTH AN TOWN OF NOR IWO OR \ . WIRING PERMIT F WE ........................ ifies that This ert has erssien to Perform ... ` \\ N NINE, wifin in the building of North Andover, Mass+ gi am g 4 t -,- .�.......}} . .a..... £ �E Lic, C . ..., ELECTRICAL L SPECT i Fee.,................ \\ 05 g Check# MEN \\ vp r - , b >- �. � � �