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HomeMy WebLinkAboutMiscellaneous - 74 Mill RoadT T 0 C Date.... 933 TOWN OF NORTH ANDOVER 0 $ . PERMIT FOR WIRING ,SSAcHU This certifies that ......... .............. has permission to perform ........5.. �"c .............. wiring in the building of ..... .q,4 - ..6 .......... ....... I ........................... I at ........ 11!...3t... p�%t.t................................. .North Andover, Mass. Fee.... Lic. NoI.J.'.X ...................................... * ........................ ELECTRICAL INSPECTOR C k-�Fj 15/9715:29 35.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 4 The Commonwealth of Massachusetts Department of Public Sofcfy BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 1200 13/40 e Use U,1 M1•r r_It Vin• �� Occupancy S Fec ilea �c blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOhK All work to be prriormed In accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL ItiFORHATION) Date 4_� - 1.2-P7 City or Town of 111,0,e7iW iQNpO//ErC To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street S Number) 711 /&/LL 14?O.p O-ner or Tenant lwemAl 441vG-4A1 0%,mer's Address SAME CJ?l8,i 97J-- 7/79 Is this permit in conjunction with a building permit Purpose of Buildin Existing Service ` Amos /_ Volts New Service Amps Number of Feeders and Ampacity, / Volts Location and Nature of Proposed Electrical Work Yes ❑ No © (Check Appropriate Box) Utility Authorization 110. Overhead ❑ Undzrdl I No. of Enter- Overhead ❑ Undgrd ❑ No. of Meters Installation of Alarm System No. of Lighting Outlets No. of Hot Tubs ' No. of Transformers Total KVA No. of LightingFixtures Swimming Yool, Above In - grnd. grnd. ❑ t Generators I KVA Co. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting t Battery Units No: of Switch Outlets ; No. of Gas Burners FIRE ALARMS. No. of Zones T `... No. of Detection and No. of Ranges ' Total- No. of Air Cond. tons Initiating Devices No. of Sounding Devices g No. of Self Contained Detection/Sounding Devices Local ❑ Municipal ❑Other No. of Disposals eat No. of Puummps Total Total Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW Connection No. of Water Heaters KW Signs No. of ' Ballasts Low Wirinoltage lxyeE No. Hydro Massage Tubs No. of Motors Total HP OTHER: �/J SmoKE �ErE�TO,e MAY 1 3 1997 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 p 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 S 4. GG Expiration Date Work to Start S -.2 - 97 Inspection Date Requested: Rough Final Signed under the penalties of.perjury:_ FIRM NAME A.D.T. SECURITY -SYSTEMS NORTMFAST ,INC. LIC. No. 1231C Licensee DONALD A BROOKS Signat e N0. 1231C Address . 60. William Street, Wellesley, _ 8 s. el. No. 413-732- 4400 Alt. Tel. No.617-431-5831 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, andthat my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S 9S e o Signature of Owner or Agent A