HomeMy WebLinkAboutMiscellaneous - 212 Appleton StreetN
Date ......... (,
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986
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
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This certifies that ...... ......
has permission to per
wiring in the bu;�Iddi g of ... .... .. . ......................
.. . . ........ . ... I ............ . North Andover, Mass.
Fee ..... L) ... . .... Lic. NAd..7sb-� ...........
1c
-YEaLEVR NYPECTOR
06/09/97 13:28 15.00 PA'D
WHITE: Applicant CANAX. Building Dept. PINK: Treasurer
Office Use Only
{GY P &tliMatil ealt of Massar4us m permit No.
n P1rintrttnettt of PuhltcttRj
Occupancy ,& Fee Checked �s
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 iso pea" blank)
o-
r APPLIdATION FOR PERMIT TO, PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMA 12:00
` (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) nate
OIC or Tbwn of NORTH ANDOVER To the Inspector of Wires:
' the U"ral nod a lies for permit to perform the electrical work described below.
0... i�P P
` L66atiori t$t4b't b Number) 2 c
• br t�niiini' - -
.
Owner's . Address . ---
�.r ,.,
' � E to this permit in conjunction with at building permit: Yes ❑ No (Check Appropriate Box)
4.
puipose$ Euiiding Utility Authorization No.
t Existing Service Amps . J Volts Overhead F1Undgrnd C1 No. of Meters
iVewi cervico Amps 1 Volts Overhead ❑ Undgrnd ❑ No. of Meters
Number df. Feeders and Ampacity
f i 1.b�itioh and 1 ittire of Proposed Electrical Work
No i!f liphtitiq fyiatltits ..
No. of Hot Ibbs )
No. of 1Yansformers 1bte1
KVA
No a w6ha'Fi lmur t
• ,rr
Swimming Pool Above In-
grnd. ❑ grand. ❑
Generators KVA
� ,�
No of �iice�ltable tlutlats
No. of Oil Burners
No. of Emergency Lighting
Battery Units
No. of Switch outlate
No. of Gas Burners
FIRE ALARMS No. of Zones
No. of Detection and
Initiating Devices
No. of Sounding Devices
No. of Self Contained
Detection/Sounding Devices
Local Municipal Other
❑ Connection ❑
No. of Aitngite
Total
No. of Air Cond. tons
No. Of Dlapotials
. No.of Hest Total Total
Pumps Tons KW
No of Dishwaiihisre
Space/Area Heating KW '
No. of t�ryaM
HeatingDevices KW
riJbi of Water H+itirs KW
No. of No. of
Signs Ballasts ��
Low Voltage
Wiring
No. Hob Mii"66'IlLbe
No. of Motors Total HP
6'1`14ER:.
?i.
,i INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws
I have a current Liability Insurance Policy including Complete stations Coverage or Its substantial equivalent. YES liYFiO I
have submitted valid proof of same to the Office. YES NO Z If you have checked YES. please indicate the type of coverage by
t ` checking the appropdati box. •t'
INSURANCE ''� SONO G OTH90/'C (Please Specify)
a D � �i (Expiration Date)
. rp Estttrtisteti Value of Electrics Work 3
" • "'� f Work to Stan " �' � Inspection Date Requested: Rough G'Final - --
Y�%
Stgttsd under a Penalties of perfury:
rye` PIRM NAME N nil 1t—i r�1.c S �`�� LIC. NO.
i /Licbi6se l Get. Signature LIC. NO.
yx \Bus. Tel. No.
t dddraei`gyp O (� _ S i \ ! `� —I -)b M ^may '0 SrFx_'�_ Alt. Tel. No.
R k dWNER'S IkBURkNCE WAIVER: 1 am aware that the Licenses does not have the insurance coverage or Its substantial equivalent as re.
quirad by Measeehusetts general Laws, and that my signature on this permit applicphon waives this requirement. Owner Agent
t t (Please check one)
Telephone No. PERMIT FEE S
?. (Sionaturs of Owner or Agent) ..aaxe