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HomeMy WebLinkAboutMiscellaneous - 1 High ST Bldg 34-� . ��i Date ...... 7.1-3VI TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .... C.R.0 has permission to perform . e:'.jT ....... t16 wiring in the building of ...... 1Vd ...... 4 ..... ht ...... . ............. X7 ...... .................... . e..., North VAndaovrr, _,as/ Fee.7 J.d.. Lic. No-fl,71 .. ........ ... ... ....... c� ?. ... .. ............ ELE IC NS CMR Check# 4424 The Commonwealth of Massachusetts Office Use Only GAESM Permit No. Department of Public Safety Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date March 19, 2003 N. Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) One.High Street Owner or Tenant North Andover Mills Owner's Address Yale 900 Chelmsford Street, Lowell (978)453-6666 Is this permit in conjunction with a building permit: Purpose of Building Commercial Existing Service Amps e New Service Amps Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work _ Yes ❑ Volts Volts No (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ No. of Meters Overhead ❑ Undgrd ❑ No. of Meters Installation of wallpack on Water Street right side No. of Lighting Outlets No. of Hot Tubs Total No. of Transformers KVA No. of Lighting Fixtures Above In - Swimming Pool grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas burners FIRE ALARMS No. of Zones No. of Detection and Total No. of Ranges No. of Air Cond. tons Initiating Devices Heat Total Total No. of Disposals No. of pumps Tons KW No. of Sounding Devices No. of Self Contained r No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices Municipal Local ❑ Connection ❑Other No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws 1 have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES ® aN,O ❑ I have submitted valid proof of same to this office. YES ® NO 11.RECEI RECEIVED If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE [R BOND ❑ OTHER ❑ (Please Specify) Estimated Value of Electrical Work $ Work to Start Signed under the penalties of perjury: FIRM NAME CROWE & SONS Inspection Date Required: Rough LIT G'rTAT(`AT. (1r)PT) Licensee JAMES B. CROWE Signature MAK 2 .(ExpZr@1' Date) 1C a:J3 LIC. NO. 1716 8A LIC. NO.1716 8A 8)453-6676-- Address 543 MIDDLESEX STREET, LOWELL, MA 01851 Alt. Tel. No. (978)251—t95 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner ❑ Agent ❑ (Please check one) Telephone No. (Sianature of Owner or Aqent) PERMIT FEE $ 75. 0 0