ELEC PERMIT APP 3/26/2009 P1 A Official Use Only
Commonwealth of�t�lassachusetts Permit No. 542
ea -m ! p of S Occupancy and Fee Checked
.���: � Department Fire erUices
BOARD OF FIRE PREVENTION REGULATIONS (Rev.1l07) (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 3/26/2009
City or Town of: SALEM To the Inspector of Wires
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&No) 41 HIGHLAND STREET
Owner or Tenant ANDY GREER Telephone
Owners Address
Is this permit in conjunction with a building permit? Yes n No n (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overheand E Undgrd U No.of Meters
New Service Amps / Volts Overheand ❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: ADD RECEPT/REHAB KITCHEN AND BATH/CHANGE PANEL ADD LIGHTS
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaries 4 No.of Cell-Sus (Paddle)Fans No.of Total
Cell-Susp. Transformers KVA
No.Luminarie Outlets No.of Hot Tubs Generators KVA
No.of Luminaries 10 Swimming Pool Above grnd ❑ In grnd ❑ Battery No.of EUnitsmergency Lightning
No.of Receptacle Outlets 20 No.of Oil Burners FIRE ALARMS!No.of Zones
No.of Switches 10 No.of Gas Burners 1 No.of Dedication and
Initiating Devices
No.of Ranges No.of Air Cond. Toil No.of Alerting Devices
No.of Waste Disposers 1 Heat Pump
No TonsKW No.of Self-Contained
Totals: _ Detection/Alerting Devices
No.of Dishwashers 1 Space I Area HeatingKW Local Municipal 1---, Other
_
_ ❑ Connection
No.of Dryers 1 Heating Appliances KW Security Systems
No.of Devices or Equivalent
Data Wiring:
No.of Water Heaters KW No.of Signs No.of Ballasts _ No.of Devices or Equivalent
No.of H dromassa a Bathtubs No.of Motors Total HP No.o Devices
or Telecommunications Equivalent
y g No.of or Equivalent
OTHER
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Attach additional details if desired or as required by the Inspector of Wires.
Estimated Value of Electrical Work 9,000 (When required bu municipal policy)
Work to Start 3-26-09 Inspections to be required in accordance with MEC Rule 10,and upon.Completion
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 [] BOND ❑ OTHER [ (Specify):
I certify,Under the pains and penalties of perjury,that the Information on this application is true and complete.. A14435
LIC NO.:
FIRST NAME: CLIFFORD ELECTRIC INC
LIC NO.: E35231
Licensee DAVID H CLIFFORS Signature
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(If applicable,enter"exempt"In the license number line.), BUs.Tel No: 978-745-1314
Address 11 PICKt4AN ROAF SALEM NA 01970 Alt.Tel No: 978-423-0107
Per M.G.L.c,147,s,57-61,security work requires Department of Public Safety"S"License: tic.No:
OWNERS INSURANCE WAIVER:I am aware that the Licensee does not have the liability
Insurance coverage normally required by law. By my signature below,I hereby waive this requirement
1 am the(check one) Owner ❑ Owners Agent n
Owners Agent Signature Tel No. 'PERMIT FEE:$_ 90.00
P2
Commonwealth of.Massachusetts Permit No. Official Use
542
' (Department of Tire Services
j06 Occupancy and Fee Checked
• LW
BOARD OF FIRE PREVENTION REGULATIONS (Rev.1/07) (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed In accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 3/26/2009
City or Town of: SALEM To the Inspector of Wires
The fee for new work(new construction or repairs)shall be three dollars($3 )per one thousand dollars ( $1,000.00)of
the valuation as shown on the building permit. Fee schedules available upon request Each permit$15.00 minimum
4-14-09 ROUGH INSPECTION,KITCHEN AND BATH NEW WORK,RECEPTACLE OUTLETS,LTGHTING OUTLETS AND SWITCHES
OLD WORK IN ALL THE OTHER ROOMS.REQUEST ALL EQUIPMENT GROUNDING CONDUCTORS COMPLETED IN ACCORDANCE
WITH 250.148.BASEMENT NM CABLE WIRING HANGING. (MARK)
8-6-09 INSPECTION,REQUESTED LIVING ROOM RECEPTACLE OUTLETS ARC-FAULT PROTECTED IN ACCORDANCE WITH
210.12(8) .REQUESTED BATHROOM HOOD FAN RECEPTACLE OUTLET TO BE GFCI PROTECTED IN ACCORDANCE
WITH 210.8(A) (1) .REQUESTED T-STAT WIRING REMOVED FROM THE COPPER TUBING AND SUPPORTED INDEPENDTLY
IN ACCORDANCE WITH ARTICLE 725.24,300.11(B) (2) .REQUESTED THE NM CABLE USED OOTDOORS IN THE RACEWAY
FOR TUE CONDENSOR UNIT CHANGED TO A CONDUCTOR SUITABLE FOR WET LOCATION ACCORDANCE WITH 300.9,
300.8(C) ,334.12(B) (4) AND 110.3(8) . (MARK)
8-10-09 PHONE CONVERSATION WITH DAVID CLIFFORD,INSPECTION BOOKED 8-11-09. (MARK)
8-11-09 FINAL INSPECTION,ELECTRICIAN ON SITE WORKING ON CONDENSOR WIRING. (MARK)