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HomeMy WebLinkAboutMiscellaneous - Foster Streetf �. c� Date .... ..�/............ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...6-4..:.. .......................................................1................... ?l.l�/, t , has permission to perform.................f�.........:..........�....................................... wiring in the building of ¢% f.�) f /( �,.....%!/ { ! at..�....T�f ;,. /�% {!„�/�1" orth Andover, Mass. /1�� �v Fee..................... Lic. No............. ....,........... ........................................... F LRCTR ICAI. 1NRPA(' M-2- Check #��� r 5002 THE COMMONWEALTH OF MASSACHL Department of Public Safety BOARD OF FIRE PREVENTION REGULATIO APPLICATION FOR PERMIT TOPER All work to be performed in accordance with the Massa (Please Print in ink or type all information) Town of North Andover The undersianed aoolies for a oermit to oerform the electrical work described below. Lo;ation ( Owner or TS Permit No. ✓��� 7 CMR 12:00 Occupancy & Fee Check",?"" RM ELECTRICAL WORK alts Electrical Code 527 CMR 12:00 Date 09 - 0,3 - 0-1 To the Inspector of Wires: Owner's Address ti,j H(), VI i.U( la ; /�{/iu�`�r�l�_11-i�{ i dU �1 () J,1 I `J Is this permit in conjunction with a building permit++ Yes I •n \ No )0 (Check Appropriate Box) Purpose of Building �C1YY1 00,ep r6 r-1 C Pd � J Utility Authorization No. 1 1q 6 5 (15 Existing Service___,:;g Q_ Amps__L9aJa-A/0—_._Voits OverheadD Undgmd New Service cX) Ampsoits Overhead %, Undgrnd Number of Feeders and Ampacity (� / /�y(� �` Lobation and Nature of Proposed Electrical Work 1' of QCQ / l� out 1�(JLIJ C,l C CLQ . No. of Meters No. of Meters OTHER: & (2JJI Q / C-, Ia IVXt 11 t'� law r C `tea 0W � tJ INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial eWivalen YES NO = ha ed valid proof of same to the Office YES= NO = If you have checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE BOND = OTHER = (Please Specify) G (Expiratio Date) Estimated Value of Electrical ork$ �� /1 Work to Start_ U>0 -k OF a Inspection Data Resquested Rough Final C(ZA Signed under �tjh/�e Penalties of perjury: ii L� / I 2 Ilave,�h i I t (Lm FIRM NAME_ eIa[I A �Ylnr(rL(. t�2C' tlCQ;1 CCIY)Q 'TC;J�r/ A✓1�Q_S% /�,{A o(IJ1'j LIC. No. A UJlY01�_ Licensee Q d (� I . �(1 1i} (f I I J (• signature LtC. NO. Address IAa I I�i1�1111� I�IUXA� ;(�IQS tJl l (U J / 1 U ��I BAft Tel! No. Q t (� - ✓ZX� ' 5a� OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ ()G (Signature of Owner or Agent) t 1 • Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above In No. of Lighting Fixtures Swimming Pool gmd gmd Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of Ran es No of Air Cond Tons Initiating Devices Heat Total Total No. of Di osal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Dishwashers S ace/Area Heating KW Detection/Sounding Devices • Municipal Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW signs Bailases Wiring . Hydro Massage Tuds No. of Motors Total HP OTHER: & (2JJI Q / C-, Ia IVXt 11 t'� law r C `tea 0W � tJ INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial eWivalen YES NO = ha ed valid proof of same to the Office YES= NO = If you have checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE BOND = OTHER = (Please Specify) G (Expiratio Date) Estimated Value of Electrical ork$ �� /1 Work to Start_ U>0 -k OF a Inspection Data Resquested Rough Final C(ZA Signed under �tjh/�e Penalties of perjury: ii L� / I 2 Ilave,�h i I t (Lm FIRM NAME_ eIa[I A �Ylnr(rL(. t�2C' tlCQ;1 CCIY)Q 'TC;J�r/ A✓1�Q_S% /�,{A o(IJ1'j LIC. No. A UJlY01�_ Licensee Q d (� I . �(1 1i} (f I I J (• signature LtC. NO. Address IAa I I�i1�1111� I�IUXA� ;(�IQS tJl l (U J / 1 U ��I BAft Tel! No. Q t (� - ✓ZX� ' 5a� OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ ()G (Signature of Owner or Agent) t 1 • Z/ Date ... *�l............ TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ........................ �................................. - ...........:................ has permission to perform�.��l�ll ...z wiring in the building of ....�1� .....!/...... f:!:f (.... --2 ................. .:.....:............................ :.... .... .......:...�............ North Andover, Mass. Fee....f ..t Lic. No/.•.��4A ..................................................................... ELECTRICAL INSPECTOR . Check # "5QG7 C.ornmonwaa[Ut o�ae�ac�tc�alh Official USC Only 2eparinr4nl cl Jira �arvica9' FR,,. t No. ancy and Fee Checked�O BOARD OF FIRE PREVENTIO RELATIONS 1/99.] Icavc blank) APPLICATION FOR PFRMI T PERFORM ELECTRICAL WORK All work to be performed in accordance will tl'e Massachuscus f_Icctrical Code (NIEC), 527 CAIR 12.00 (PL1-ASE PRINT IN INK OR 7'YPG : l LL IN ORAL -f7 -10N) Da(e: 0 9 'DW G4 City or Town of: J-loafl) Ando✓ef TO the inspector of I -Vires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Co�V ✓ F) -Ya+ / 00 (x. W 53 Owner or Tenant Owner's Address Telephone No. TC)- OVftolo Is this permit in conjunction with n building permit? Yes ❑ No � (Cltecl; ,\ppi-opria(c Box) Purpose of Building (ImIn rdal *�S3 Utility Authorization No. OI L4 Existing Service `aG Amps I o /SAO Volts. OvencCad� Undgrd ❑ No. of Meters New Scrs_icc. Amps �_v._ / _1UN'olts Overhead Y,4 Undgrd ❑ No. of Nfeters Number of Feeders and Ampacily Location and Nature of Proposed Electrical Work: No. of Recessed Fixtures No. of Lighting Outlets No. of Lighting Fixtures No. of Receptacle Outlets No. of Switches No. of Ranges No. of Waste Disposers No. of Dishwashers No. of Dryers Ileo. on Nvatcr hlcalcrs W. INo. Hi-dromassage Bathtubs Completion of the No. of Ceil.-Susp. (Paddle) Falls No. of [lot Tubs table fnal+be n•ah-c(l by the hfsj)cctor No. of Total 'fransformcrs K V A Generators KVA Sninuuing POU] Above In- Ivo. of tinergenc}-Lighting b rnd. rnd. EJ Batter Units No. of Oil Burners FIRE ALAMAIS No. of Zones No. of Gas Burners No. of Air Cond. Tons llcatPump Number Tons ................................................... totals: Space/Arca Heating KIV Heating Appliances Ivo. oI Sens No. of Motors K1V No. of Ballasts Total h11' Ivo. of Detection and Initiating Devices No..of Alerting Devices fvo. of Sell -Contained Detection/Alerting Devices Local1VIunicipal ❑ Connection El attic, Security systems: No. of Devices or Equivalent Data NViriug: No. of Devices or Equivalent rc!ccom:a;Ili cat:ons !1`iring: No. of Devices or Eouiv;ilent I I'i rrs. LOTHER: amy OUB pima Sa W . ia I I Iifitach additional detail if desired, or as required bin the /nsp•ector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE P BOND ❑ OTHER ❑ (Specify:) 0 (Expir lion Da(c) Estimated Value of Electrical Work: (When required by nunnicipa ,otic}.) GVork_to Start: 9-9-0,4 Inspections to be requested in accordance with MEC Rule 10, and upon conpietion. I cerfifj , under the pains and penalties of perjmy, that die inforatatiort ort this application is trite alyd.complete. FIli�1 N:•„IE: C FMorri I is aUrir LIC. NO.: '(D(nd(o Licensee: C(I'( C� t �nrri, (, s;gnature J �. LIC. NO.: (/(applicable, cuter "c1'011pi - in thhhe �/�i�ce�r{{se munber life.) Bus. Tel. No. Sia -15aa Address: 1,4,9�iC1A U ht 1i kKd f A W IA YU 10 O l 3 Alt. Tel. No.: ONtNER'S INSUI:ANCE ]VAI VE12: I am aware lh t the Licensee does not have the liability insurance cm-crage normally required by law. LI}• my signature below, I hereby waive this requirement. Ian, the (check one) ❑ owner ❑ owner's agent. 1 Oivncr/Agent o0 Signature 'Telephone No, FJj,7RJ1fITF-E-E: S35 Date.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... ....................... .................... has permission to perform/! llglg wiring in the building of ZZ, at ................................ North Andover, Mass. Fee,-.-,,-".: ........... Lic. No.,/-// ....................................................... ELECTRICAL INSPECTOR Check 'I 4987 THE COMMONWEALTH OF MAS Department of Public Safety BOARD OF FIRE PREVENTION REGI APPLICATION FOR PE Ail work to be performed in accor (Please Print in ink or type all information) Town of North Andover `° .Permit No. V V V � o r ETTS C 0-0ONS 527 CMR 12:00 Occupancy & Fee Che f ' PERFORM ELECTRICAL WORK Massachusetts Electrical Code 527 CMR 12:00 The undersigned applies for a permit to perform the electrical work described below. LoFation (Street & Number. Owner or Owner's Date 0 — 22 �y`t To the Inspector of Wires: Is this permit in conjunction with a building permit Yes /• \ No )` (Check Appropriate Box) 1 Q Purpose of Building Ccw,, l " c(i (3.1 (Q-) ) Utility Authorization No. I 2 q CQ b Existing Sere cP(3Amyps�LVoits OvertmeadO New Service ,�(i Amps OV oils Overhead s Numbpr of Feeders and Ampacity Logation and (Nature of Proposed Electrical Undgmd • No. of Meters Undgmd • No. of Meters OTHER: i cxo-Pz n ngxcnAer r) o -MCC sf- INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantialequivalent 0�E> NO = have submitted valid proof of same to the Officetp = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box. CMVUNRCNE_=�BOND = OTHER = (Please Specify) U!Ckb! I 1 0U/Oq (Expiration Date) Estimated Value of Electrical Work$ Work to Start L g2 , V D F O a -ba Q,{ Inspection Date Resquested Rough Wil 0-0.1 j Final AN Signed under the Penalties of perjury: // "" .FIRM NAME F ✓i �� YYlnkrrl l l �2Ci fI (lt Covli i'(�( (/ � VIC •- LIC. NO. A 1 0( Q aU us. Tel No. Ll M - -5 6 Y3 L Address Ha `IQV���Ill�i AI�.QS61,�i I ISA On Bus. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licen es does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above In No. of Lighting Fixtures Swimming Pool gmd gmd Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of R.6 es No of Air Cond Tons Initiating Devices Heat Total Total No. of Di sal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices • Municipal • Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bailases I Winn No. Hydro Massage Tuds No. of Motors Total HP OTHER: i cxo-Pz n ngxcnAer r) o -MCC sf- INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantialequivalent 0�E> NO = have submitted valid proof of same to the Officetp = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box. CMVUNRCNE_=�BOND = OTHER = (Please Specify) U!Ckb! I 1 0U/Oq (Expiration Date) Estimated Value of Electrical Work$ Work to Start L g2 , V D F O a -ba Q,{ Inspection Date Resquested Rough Wil 0-0.1 j Final AN Signed under the Penalties of perjury: // "" .FIRM NAME F ✓i �� YYlnkrrl l l �2Ci fI (lt Covli i'(�( (/ � VIC •- LIC. NO. A 1 0( Q aU us. Tel No. Ll M - -5 6 Y3 L Address Ha `IQV���Ill�i AI�.QS61,�i I ISA On Bus. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licen es does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent)