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0029 1ST ST ROAD - Electrical Permit 110 INSURANCE WAIVER . . . . . . . .YES . . . . . . . . . . . . . NO. . . City of Salem - City Electrician NO. . . ;. . . . . . . . . . . . . B.P.#. . . . . . . . . . . . . FEE. . . . . . . . . . . . . . . . . . . . . . . . . . APPLICATION FOR WIRING PERMIT ROUGH INSP . . . . . . : . . . . .'1. . . . . . . . . . . . FINAL INSP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Lafayette Street SIGN INSP. . . . . . . . . . . . . . . . . . . . . . . . . BURNER INSP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Salem, MA 01970 RE--INSP . . . . . . . . . . . . . . . . . . . . . . . NO ACCESS/FILED. .C�".. . . .L�'�. . . +! 978-745-6300 SERV. INSP. . . . . . . . . . . . . . UTILITY AUTHORIZATION#. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fax 978-745-4638 M.E.N. DATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date work to commence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .to wire premises at CHECK WORK TO BE DONE Street and No. G7g�7. . .��� 157- . U.P New Work [ ]. \/ VOID ONEYEAR Owner. . . . .Z:J—•V • . .�'� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Old Work rT1 [ ] Occupied by. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .FR.OM. DATE:OF.PERMIT service o [ ] Used for Dwelling. . . . . .. . .Condos . . . . . . . . . . Industrial . . . . . . . . . Commercial . . . . . . . . . No. of Meters `"' nn [ ] Wiring Service: New . . . . . . . . . ... . . . . . . . . . . . .Temporary . . . . ... . . . . ..... . . . . Electric Electric Sign [ g [ ] Service change from. . . . . . . . . . . . . . . .Amp to. . . . . . . . . . . . . . . .Amp . . . . . . . . . . . . . . . . . Gas Pump n O [ ] Pools Service Grounded to . . . . . . . . . . . . . . . . . . . . . . .Ground Size. . . . . . . . . . . . . . . . . . . . . . . . . . Swimming rl�4s q [ ] Single Phase . . . . . . . . . . . . . . . . . . 3 Phase. . . . . . . . . . . . . . .3 Phase,4 Wire. . . . . . . . . . . . Voice Data Outlets [ ] How Installed: Conduit. . . . . . . . . . . . . . . . . . . . . .S.E. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Range Overhead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Underground . . . . . . . . . . . . . . . . . . . . . . : . . Water- Heater O 33 [ ] Existing Service: Electrically and mechanically good condition?... . . . . . . . . ... . . . . . . . . . . . . . . . Dryer [ Signature of Applicant Gas-Oil Burner 9 PP S //G . . " " " " ' . ' . " ' • . . . No. of Circuits [ ] Firm's Name. .} O I urner Tech #. p ic. No. E . . .� . L . . [ ] Firm's Tele hone N 'J� . . No. of Fixtures 1��. . . Street No/�. ,.1c<-/. 1U�. . ... . . . . .:Firm's Lic. No. E . . . . . . . . . . .. . . . . . . .. . . . . . No. of Receptacles [ ] City . . . . . . LLL i�. .N )L+• . . . . .• Master Firm's Lic.A. ... . . . . . . . . . . . . . . . . . . . . No. of Motors,. [ ] Ready for-first inspection . . . . . .l)3Z`-l� 'Lic. No.C: .. . . . . . . . . . Lic; No. D .. . . . . . . . . . Electric Heat [ Lic. No.A or C. . . . . ... . . . . . . . . . . . . . . . . . . . . Fire Alarm System [. ] NOTE: Wire must not be covered in without permission.This card to be filled out before Burglar Alarm [,] work commenced. Notify this office at the completion of all work including finish. Smoke Detectors• [ ] All captions shall be filled in COMPLETELY. NOTATIONS ON BACK. HVAC Units [ ] The fee for new work (new construction or repairs) shall be three dollars ($3.00) per one thousand dollars ($1,000.00) of the valuation as shown on the building permit. -Fee schedules available upon request. i s Each permit $15.00 minimum s Commonwealth of Massachusetts Official Use only ` Permit No. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 1 CMR 12.00 (PLEASE PRINT IN INK OR TYP LL FORMATION) Date: o City or Town of: To the Inspec r of Tres: By this application the undersigned ives notice of is or intent' to perform the electrical work described below. Location(Street&N ber) ZIU Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system Completion of the followin table may be waived by the Inspector of Wires' No. of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA NoO.of'L`ighiin-,Ouitlets No:of Hot-Pubs ---� =-- - — Generators- No.of Lighting Fixtures Swimming Pool -:w ,.._.:KVA_ __. _ Above In- o.o Emergency Lighting rnd. rnd. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No. of Switches No. f:.of, •_A?„rr,eTs o.o Detection an initiating Der ices _ No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers . Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances Kam, Security Systems: No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydr omassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. INSURANCE A_NCE 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:) (Expiration Date) Estimated Value o E ect ' al Work: POW-,- (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under th pat s and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO-: 1 r,. 1r Licensee: John- S. Bassett ` Signature LIC.NO.: 1533C (If applicable, enter"exempt"in the license number line.) Bus.Tel.No.: 603 594 5928 Address: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Lid, see does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. , two ADTSecurity Services,Inc. 18 Clinton Drive Hollis,NH 03049 Fire & SeCUr/t)/ Tele:603 594 5900 Fax:603 881 7282 CITY OF SALEM- ADT ELECTRIC DEPARTMENT-1 100) AUG 20,, P 1; August 19, 2003 Town of Salem Electrical Inspector 44 Lafayette St. Salem, MA 01970 Attn: Mark Rochon Dear Mark, Per your conversation with Joe Demeo,please cancel the permit for 29 First St. -Unit D this job has been canceled. The owner of the residence is J.V. Ehrlich. Thank You Barbara Bouley