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HomeMy WebLinkAboutMiscellaneous - 1 Singlewood LaneThe Commonwealth of Massachusetts Office JUse Only Permit No. �`?' Z Department of Public Safety Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3190 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts-Electdcal Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date February 24, 2006 City or Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 2357 Turnpike Street owner or Tenant Valley Realty Development LLC Owner's Address 2357 Turnpike Street, North Andover, MA Is this permit in conjunction with a building permit: YesE] No❑ (Check appropriate box) Purpose of Building Pump Station Utility Authorization No. --444M Existing Service Amps / Volts Overhead❑ Undgrnd❑ No. of Meters New Service 100 Amps 120/208 Volts Overhead❑ Undgrnd Jt❑ No. of Meters 1 Number of Feeders and Ampacity 341, 146 gnd Location and Nature of Proposed Work Furnish and install Power for Pump Station Other: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws: YES ❑ NO ❑ I have a current Liability Insurance Policy Including Completed Operations Coverage or its substantial equivalent. YES ® NO ❑ I have submitted valid proof of same to this office. If you have checked YES, please indicate the type of coverage by checking the appropriate box: RANCE ® BOND[] OTHER❑ (Please specify) Carlin Insurance Expiration 7a -Fe ated value of electrical work $ $150,000 (Total Const. Cost) to start Immediately Inspection Date Requested: Rough will call Signed under the penalties of perjury: FIRM NAME Consolidated Electrical Services a division of Licensee Lawrence Pantano Signature Final will call LIC. NO. 17502A LIC. NO. Same Address 661 Pleasant St. Norwood, MA 02062-4603 Business Telephone No. (781)-769-7110 Alternate Telephone No. (800)-628-7110 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or it's substantial equivalent as required by Massachussets General Laws, and that my signature on this permit application waives this requirement. ❑ Owner ❑ Agent (check one) Cgnature of Owner or Agent) Telephone No. Permit Fee $ 225.00 Total No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA Above In - No. of Lighting Fixtures Swimming Pool and rnd Generators KVA No. of Emergency Lighting Battery No. of Receptacle -Outlets No. of Oil Burners units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and No. of Ranges No. of Air Cond. Total tons Initiating Devices Heat Total Total Flo. of Disposals No. of Pumps Tons KW No. of Sounding Devices �i. No. of Self -Contained of Dishwashers Space/Area Heating KW Detection/Sounding Devices No. of Dryers Heating Devices KW Local 0 Munlc. Conn. Other No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts iwlrin,, No. of Hydro Massage Tubs No. of Motors Total HP Other: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws: YES ❑ NO ❑ I have a current Liability Insurance Policy Including Completed Operations Coverage or its substantial equivalent. YES ® NO ❑ I have submitted valid proof of same to this office. If you have checked YES, please indicate the type of coverage by checking the appropriate box: RANCE ® BOND[] OTHER❑ (Please specify) Carlin Insurance Expiration 7a -Fe ated value of electrical work $ $150,000 (Total Const. Cost) to start Immediately Inspection Date Requested: Rough will call Signed under the penalties of perjury: FIRM NAME Consolidated Electrical Services a division of Licensee Lawrence Pantano Signature Final will call LIC. NO. 17502A LIC. NO. Same Address 661 Pleasant St. Norwood, MA 02062-4603 Business Telephone No. (781)-769-7110 Alternate Telephone No. (800)-628-7110 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or it's substantial equivalent as required by Massachussets General Laws, and that my signature on this permit application waives this requirement. ❑ Owner ❑ Agent (check one) Cgnature of Owner or Agent) Telephone No. Permit Fee $ 225.00 n �4 O :o Town of NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PERMIT NO.:1,74-7-7 PROJECT: )�-4e A'I )r 5 INSPECTION DATE: T - Z'7- 0(7 UNIT NO.: FLOOR: WING: REMARKS: sQiLV, Gc- to BUILDING NO.: r3 100 A Z.o� vo f �" t 5p � -4-t- -5� 7 F , 4,�) Excavation - depth and soil conditions Framing - Other: Date: Date: Date: Inspector Inspector Inspector. Footings and foundations and drains - Insulation - Other: Date: Date: Date: Inspector Inspector Inspector Electrical - rough - Plumbing and/or gas - rough - Other: Date: Date: Date: Inspector Inspector Inspector Electrical - final �� Plumbing and/or gas - final Other: Date: �"" a�— g 6 Date: Date: Inspector Inspector Inspector ire Dept - oil burner, tank, stove, smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: C of 0# Inspector Inspector Inspector PERMIT NO.: UNIT NO.: O• wO�ty 140 G Town of NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PROJECT: IFF, H (-A-wWS INSPECTION DATE; FLOOR: WING: REMARKS: "'� �t�+ti�t10 TA olsi c)ni-0e 2G/?OL4 ) 30 41h1r�lp. Z - ZZ • 06 BUILDING NOY Bu,10'0�17 J c v Excavation - depth and soil conditions Framing - Other: Date: Date: Date: Inspector Inspector Inspector Footings and foundations and drains - Insulation - Other: Date: Date: Date: Inspector Inspector Inspector Electrical - rough - PA t Plumbing and/or gas - rough - Other: Date: j — Z Z '" O Date: Date: Inspector �%r Inspector Inspector Electrical - final Plumbing and/or gas - final Other: Date: Date: Date: Inspector Inspector Inspector Dept - ,ire oil burner, tank, stove, smoke detectors Final inspection 4 Certificate of Use and Occupancy Date: Date: Date: —Cof 0# Inspector Inspector Inspector