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HomeMy WebLinkAboutMiscellaneous - 257 Boston Streetu J 0 En ft0 Of Lfommnnw alth of A` n ,� of�c. �.. I9rparttntttt of Public $nf trg Occupancyi. 6 Fee CMclted BOARD OF FIRE PREVENTION REGULATIONS 521 UIR 12:00 Lyso Pail"' bla* i APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massacnusetts Electrical Code, 527 CMR 12.'00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dats 11 /a — Z 7 Q* or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to Perform the electrical work des 'bed below. Location (Street 8 Number) 1 ll 1 J SAO v� p� 1 S{ 'OPV v►? 5 Owner or Tenant Pa 1r, n .✓► 10 (� / 2' ..r Owner's Address Is this permit in conjunction with a building permit: Yes No C (Check Appropriate Box) Purpose of Building 12 tic ? n //,z yl a Utility Authorization No. 1.t Existing Service -a— Amps 1 I y n Volts Overhead _� Undgrnd Lv', No. of Motors „_ •'i New Service Rnn Amps IcRO/-) y0 Volts Overnead _ Uno rna 9 C No. of Meters Number of Feeders and Ampacity _�_ - lo O A Yn A Location and Nature of Proposed Electrical WorK 0 A seyy1 r C041i%YI C2`/O 1/I P I ri W1 i r� . 1��►i' 11 P rrV 1 C U7 17 No. of Lighting Outlets I No. of Mot %::sTotal No. of Transformers ransformers i KVAAoCi No. of Lighting Fixtures Swimming Pcoi grf_o — in- t— rno. _ grna. I Generators KVA !f' No. of Emergency Lighting No. of Receotacie Outlets No. of Oil turners Battery Units No. of Switch Outlets I No. or Gas ?urrers FIRE ALARMS No. of Zones No. of Ranges I No. cf Air Czr.c. Ola' No. of Detection and :cns Initiating Devices NO. Of Oisoosals I No.of Heat Tocai oiai Pur -::s :ons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers I SoacerArea Heaur.g K:/ Detection/Sounbing Devices No. of Dryers I Heating Cevices KW Local —' Municioal Other Connection No. of No Low voltage No. of Water Heaters KW I Signs 9adas:s Wiring No. Hydro Massage TUDS I No. of Momrs -otai HP OTHER: INSURANCE COVERAGE. Pursuant :o Ine reauvements Of !.tassacausecs ;eneral Laws I have a current Liability Insurance Policy tnctuaing Ccmc:etec Ccerations Coverage or its substantial equivalent. YES = NO I have suomineo valid proof of same to the Office. YES = NO = It you nave cnecKed YES. please indicate the type of coverage by checking Ina appropriate oox. INSURANCE = BONO = OTHER = (Please S: ec:"/) (Expiration Oates Eatimaleo Value of WOCtnCal Work S . Work to Start Signed unser the Penalties of perjury: FIRM NAMEc�.22 4 Licensee - _ �!I VY) v° 4 14 Insoec:ion Address r x W/i !, / a -C 'P , 7,,- OWNER'S rOWNER'S INSURANCE WAIVER: I am aware quireo by Massachusetts General laws. ane (Please check ones- (Signature at Owner or Ues:ec: Rougn Final tic. 1 �•rJ E of NO* �O� •6��,'� o Th• V � a O * O ti'o A yr •, Bus. Tel. No. O r � -?J lL –b h 0 S/ All. Tel. No. T---� �t�verage or its substantial equivalent as to. ;Qroouiremen6 Owner Agent s 11"A ,C'4USETTS * O isCC, OA. ate�/�j2 SRT asAeNissf esth�t /QM'T Qt oo th °Ay ? tOAe� f ��R �tv L o F ��. G fid' �'z . �'•• '��/V SFR ae 154 >`� _ • Lac '�`:�`�_ ••••., o,�•�; R.,.�, •• cg ' & ngOepr ��Rlcq<INSA °C,16`e� R N pNk Teas`` r.. tint (fummIIumalih of fflu.iadpnztW Erpm-tmrnt df Publit $nfittq BOARD OF FIRE PREVENTION REGULATIONS 521 CMR 12:00 pili. u;. o pw tttt No. Occupancy d I'" chucked oil 3M poetic blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massacnusetts Electrical Code, 527 CMR 12.100 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 1/ -/,;� _ 7 t* or Town of _ NORTH ANDO_VFR To the Inspector of Wires:' The udersigned applies for a permit to perform the electrical work descr*bed below. Location (Street & Num nl d 13 -9 .S-io Y\ i R 9, Lz1, n d �i t S � �`i�y r► Owner or Tenant & VA P r y Owner's Address Saw IF I No. of Gas :urgers Is this permit in conjunction with a building permit: Yes No C (Check Appropriate Box) Purpose of Building ac I& ! / n a Utility Authorization No. Existing Service aQ Amps J°�n.J' a y n Voits Overhead �I Undgrnd L� No. of Meters New Service c�On Amps � fl0 Volts Overnead _ Unogrno No. of Meters /n1 Number of Feeders ana Ampacity 2 a d o A Yn9 P No. of - vo at I Signs ?a lass Location and Nature of Proposed Electrical Work 0 ( so t V 1 r P l %11 C'04 I t)- ZZQ 14 62d — sexy 1c ill owe& iaew wlih s-tvcee No. of Ligntkng OutletsI No. of '-tot ' ^s I No. of Transformers Total KVA No. of Lighting Fixturesi Sw mming P^oi ADave.— in- r— " I grn.a. _ grna. '_ Generators KVA No. of Receotacie Outlets No. of Oil Surners No. of Emergency Lighting Battery Units No. of Switch Outlets I No. of Gas :urgers FIRE ALARMS No. of Zones No. of Detection and Initiating Device& No. of Sounding Devices No. of Self Contained DetectioniSOunokng Devices Local —' Municipal ^Other Connection No. of Ranges I No. ct Air Czr.c. iO131 :cns No. of Disposals I No al Meat 7btai 701at aurres :ons 1(14 NO. Of Dishwashers I SoacerArea Meal r0 K`,4 i No. of Oryers I Heating Cevlces KW No. of Water Heaters KW No. of - vo at I Signs ?a lass Low voltage Wiring No. Hydro Massage Tubs 't I No. of Motcrs -otai HP OTHER: INSURANCE COVERAGE. Pursuant to the reaulrements of Massac-users ;eneral Laws I have a current Liability Insurance Policy lncluatng C me stet Cceranons Coverage or its substantial equivalent. YES = NO = I have suominea valid proof of same to the Office. YES = NO = If you nave checKea YES. please inoicate the type of coverage by checking the abproonate box. INSURANCE = 70NO = OTHER = (Please Scec:",,) Estimated value of E!sctncal Work S (Excinsuon Oatet Work to Start Insoec:fon Date Aacues:ec: Rougn Final Signea unser the Penalties of perjury: FIRM NAME0� UC. NO. �_,;251�. Licensee ,�taV)n 17 S gra: re / ,nuc. H10..,� .INa. d -q-2 _6 o Atltl►ess L%l,<o �7c YYl a 1 ot-� Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the t_:censee toes not nave the in3urance coverage or its substantial equivalent as to. ouireo by Massachusetts General Laws. ana that my signature on 77,—.emu, aopticatrOn waives this requirement. Owner Agent Mease checx ones• ISignature of Owner or Agenn sleonone No. PERMIT FEE S Date//—. ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING 8 ... ... ....... This certifies that ....... ..................................... I _ -.1 has permission to perform -'z:........................... _-, 4............................................ r- ) �-....�0 wiring in the building of .... .................... .................... :8 at xm ...... ...................... o .......... . North Andover, Mask CU Z ............................................................. Fee.) .. Lic.No62 VAELECTRICAL INSPECTOR �-- Z -2!f 1.5 7 WHITE: Applicant CANARY: Building Dept. PINK: Treasurer i .a �,(t����. .�r}F.r. Office Us. oNy V4E t:��.Cain 1f ��Jzts Permit No. t _ �t}Tt�z ti Of tL6lia: - Occupancy A Fee Chocked 3140 (leave bf.*) BOARD OF FIRE PREVE?MOH REGULATIONS 527 CUR 11.0 APPLICATION FOR PERMIT TO- PERFORM ELECTRICAL"WORK AI! work to be pertorrried in accardance with the Massac iusetu Electrical Code, 527 CMR 12:100 (PLEASE PRINT IN. INK OR TYPE ALL INFORMATION) Date M* or Town of NORTH ANnOVER To the Inspector of Wires: The udersiened aoolies for a permit to perform the electrical work described below. Location (Street 8 Owner or Tenant Cwner's Address ZI 10 WX Is this permit in caniunc:ion/ with a duilcirg cerrtit: Yes _ No r (Check ApCroonate Box) Pumcse of 3uiiding L1Z�1(� Y) G Utility Authcnzatien No Existing Sarfice. Amps __! Icits Cverread '_ Uncgrne Ei U d C No. of Meters New Service Amps lolts Cvernead _ ncgm No. of Meters Numaer of Feeders and Ampacity Location and Nature of Proposed E:ec:ncat 'Nor- No. at L:gnang Cucets ' No. -_. acs i No. cr ranstarmers Total . KVa No. ar Lig-ung = xtures 5 S«,r...rn:rg . grnc. _ __c. Generators KVA No. of Receotac:e Cuttets No. =t Switcn Cuttets No. at Ranges No. ct Cisccsats No. ai Cisnwasners No. =t Cit Burners I No_ of Sas S::risers Na. 4.r .: r. C. -,tat :ns NC.=i _ ea:_s -ons at No. =t=:-ergency ::gnang j Saner,, Units FIRE .>LARMS No. of Zones � No. of Cetection aria j Inuiaung Oevicas I Na. or Sounaing Cevices No. a. Sed Cantairtee ! �atect:cnisouncing -::avices — Munic:oai I =eat Omer No. at Cryers -eanng =evices <�� Cannec•:on _ No. or No. =t I Law 'icitage I i No. at Water Heaters KW i Signs 3a:las:s '•nlinnc I t No. Hycro Massage Tubs No. of Motors -bras i4P CTH INSURANCE CCV=PAGE. Pursuant :o the 'ecC:rerner:s = :tas$aC'.CSets general Laws I rave a current L apiiity Insurance Raic/inC_c:rg _,,.._.o_tec Ccerancris Coverage or its suastantial ecuivatent. YES = NO _ nave sucmttrtea vatid proof at same :o Brie C'cs. YE:` NO _It ';cu ve cnecxec Y==. :tease inctcats :ne ype at coverage =v c.^.ecxtng the aoc nate pox. bh 4v f bee. 9 INSURANCE V NO = OTHER C tP'ease S=ec:�fl (Expiration oa[et _surnatea Value at E?ecirtcal Work 5 worx to Start iru: ec=en Casa ;;ec-.;es:ec:L Rough Final Signec uncer the Penalties of perluty. LIC. NO. F: -,RM NAMELce- 11C. NO. us. L censee �'gnan:re_� ^O 60 _�al. No. ACCress � V ��-.l,�Qc � Yno-r� .pit. -ei. No. CWNER•S INSURANCE WAIVER: 1 am aware that re t-censee Ices nct nave :rto e insurance verage or its suostantial eautvalent as -e- cuaea cy Massaenusetts Genera[ laws. aria that aty signature on t >s permit acCucattan waves tnts reautrement- Own Agent (P!ease cnacx oriel eiecrone No. PsgmfT FE= S (Signature at Owner or agertt) :5565 N2 1326 Date.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING CL This certifies that ...... 1�j ... ...... has permission to perform .........t! ...... C) ....................... it wiring in the building of .... P.!?ct ....... ..................................... at ........ . ....... �.r ........... North Andover, Mass;�- Klf), e o! Fee..T�� ............ Lic. No.p,� �o ............. ............................................................... ELECTRICAL INSPECTOR C k ff - 1(0(-) WHITE: Applicant CANARY: Building Dept. PINK: Treasurer