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HomeMy WebLinkAboutMiscellaneous - 138 Dale Street C,� CEJ r m F N° 2574 Date...... .... .. ..... I AORT11 TOWN OF NORTH ANDOVER PERMIT FOR WIRING �,SSACMuj This certifies that ........ t f I r r�r q rI nr er ��C .�...............................�..y ............................... 7 P rrv� � rl�i% F has permission to perform ....... ............. .........�............................................. wiring in the building of..... .'.`..Q.r..�...+f�............ ,.Jp /7 a, at....1....... .>�............. ..5+..J.....��..cc.5.r. North Andove 17 S. ........... Fee...... Lic.No.—/..... .� / CTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer The Commonwealth of Massachusetts FOR OFFICE USE ONLY Permit No. Department of Public Safety Occupancy &Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work will be performed in accordance with the Massachusetts General Code.527 CM1 R 2:00 (PLEASE PRINT IN INK ORTYPEPE ALL INFORMATION) Date '77/9 1 - © 0' City or Town of / Cd 7 Q � L-a cP To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below: Location(Street and Number) !3 JP ba le -rz� Map: Loi: Owner or Tenant 49 4�ve Zone: Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. 0060-700 Existing Service ��� Amps /.�,,, / Volts Overhead El Underground ❑ No.of Meters New Service 100 Amps _L iC�v Volts Overhead ❑ Underground ❑ No.of Meters Number of Feeders and Ampacity Logation and Nie of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers J0, Total KVA No.of Lighting Fixtures Swimming Pool Above grnd. ❑In-grnd.❑ Generators KVA No.of Receptacle Outlets No.of Oil Burners No.of Emerg.Lighting Battery Units No.of Switch Outlets No.of Gas Burners FIRE ALARMS No.of Zones No.of Ranges No.of Air Cond. Total Tons No.of Detection'and No.of Disposals No.of Total Total Initiating Devices Heat Pumps Tons KW No.of Dishwashers Space/Area Heating KW No.of Sounding Devices o.of Dryers No.of Self-Contained y Heating Devices KW Detection/Sounding Devices No.of Water Heaters KW No.of Signs No.of Ballasts Local❑ Muncipal Connection ❑ Other 6No.of Hydro Massage Tubs No.of Motors Total HP Low Voltage Wiring OTHER: INSURANCE COVERAGE:Pursuant to the requirements of Massachusetts General Laws 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.YES❑NO❑ If you have checked YES,please indicate the type of coverage by checking the appropriate box. INSURANCE❑BOND❑OTHER❑(Please Specify) Estimated Value of Electrical Work$ (Expiration Date) Work to Start 13-- ® O Inspe 'on to R quested:Rough Final Signed under the penalties of perjury: FIRM NAME ELECTRICAL DYNAMICS, INC. A13881 LIC.NO. Licensee. GARY R. LETOURNEAU Signature LIC NO. A13881 Address 72B CONCORD STREET, NORTH RE I 0 4 978-664-1050 Bus.Tel.No. Alt.Tel.No. JWNER'S INSURANCE WAIVER:I am aware that the Licensee DOES NOT HAVE the insurance coverage or its substantial !quivalent as required by Massachusetts General Laws,and that my signature on this permit application waives this requirement. owner I-] Agent❑ (Please check one) Telephone No. PERMIT FEE$ (Signature of Owner or Agent) INSPECTION RECORD Date Notes — Remarks Inspector