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0041 A FEBERTY HALL AVENUE - Electrical Permit 376 NO...3.26 yB.P .................. FEE.. City of Salem-City Electrician SP.. APPLICATION FOR WIRING PERM ROUGH IN' FINAL INSP . ............ SIGN INSRI................................ . ............. BURNER INSP....................... ..... 44 Lafayette Street RE-INSFI�.'C............................................ NO ACCESS/FILED...................................... Salem,MA 01970 978-745-6300 SEFW.INSP......................................................SEQUENCE#...................................... Fax 978-745-4638 We shall commence ....................to wire premises at CHECK WORK TO BED&4E Streetand No..///-/5, "- VOID- ONEYEAR New Work an PERM /CEiR Owner..........................4V..........................'. * ' * Occupied by................................. .I... FROM.DATE Old Work Service Used for Dwelling. Fq . . . . . . Condos . . . . . . . . industrial . . . . . . . . . . Commercial_ No.of Meters Wiring Service: New............................. Temporary..........................r....I.... Electric Sign C)C*) CM Service change from....................Amp.to....................Amp...............I........... Gas Pump .4 Service Grounded to.............................. Ground Size.................................. Swimming Pool Single Phase...................... 3 Phase......................3 Phase.4 Wire................... Siding How Installed: Conduit................................. S.E...:................. .............. Range Overhead..:......................:............. Underground................................. Water-Heater _U Dryer Existing Service:Electrically and mechanically good condition?.....:................................... Gas-Oil Our Signature of Applicant.....................I.........................................I............ No.of Circuits J�� Firm's Name................................................................................. No.of Fixtures Firm's Telephone No.............................. Lic.No. E................................... No.of Receptacles Street No..................................Firm's Lic.No. E................................... No.of Motors City.............................:..... '.'Firm's Lic.No. A.................................. Electric Hea Ready for first inspection.........;..... ............ ............................I............. Fire Alarm NOTE: Wire must not be covered in without permission. This card to be filled out before-work Burglar Alarm commenced..Notify this office at the completion of all work including finish. All cap- Smoke Detectors tions shall be filled in COMPLETELY. NOTATIONS ON BACK. The fee for new work ( new construction or repairs ) shall be two dollars ($2.00) per one thousand dollars ($1,000.00) of the vaWation as shown on the building permit. Fee schedules available upon request. Each permit $10.00 minimum ommonwea t o a,9achu9ettJ Official Use Only 2cc� � erartment o/Jire Service] Permit No. BO?�RD OF FIRE PREVENTION REGULATIONS Receipt No. c APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 2.076/ (PLEASE PRINT IN INKKOORgT�YPE ALL INFORMATION) Date: �� /A City or Town of: .Jny 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 and Number) . +1 Map: Lot: Zone: 'Owner or Tenant :IrCnw A, Telephone No. q ch '1+I —��J Owner's Address 4 hL� Is this permit in conjunction with a building permit? Yes YNo ❑ (Check Appropriate Box) Purpose of Building e UtilityAuthoriizatio'n No. Existing Service ZOO Amps �/12�Volts Overhead E/ Underground ❑ No.of Meters Z New_Ser_vice _ . :Am s___ .G - p / _ Volts Overhead` T__Underground 0_ No.of Meters Number of Feeders andAmpacity Location and Nature of Proposed Electrical Work: f SfiG( ` Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No.of Ceil.-Susp. (Paddle)Fans No.of Transformers Total KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures 2_ Swimming Pool-Abovegmdl ❑ In-gmd. ❑ No.of Emergency Lighting Battery Units No. of Receptacle Outlets 1-2 No.of Oil Burners FIRE ALARMS No.,of Zones No. of Switches No. of Gas Burners No.of Detection and Initiating Devices No. of Ranges t No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons. KW. No.of Self-Contained Totals: Detection Alerting Devices No. of Dishwashers Space/Area Heating KW �� ❑. Municipal El. Other i Connection No.of Dryers 4 Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water Heaters KW No.of Signs No.of Ballasts Data Wiring: No.of Devices or Equivalent No. Hydromassage 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. SURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee rovides proof of liability insurance including"complete 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. a _ CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify) r# Estimated Value of El cal Work: i (Expiration Date) (When required by municipal policy). i Work to Start: I I I IZJ 0 Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certi ,`under the ains and penalties o er u ,that the information on this application is true and complete. .h' � P P .f P J � PP P FIRM NAME::e — � �' LIC.NO.: A 1 J 2 Licensee: y l�G�CST Signature LIC.NO.: '(If applicable,enter "exempt" in the license number line). Bus.Tel.No.778`'I??—5852 Address: MIR O( Z?j Alt.Tel.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the lia ' ity insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) Yowner ❑owner's agent Owner/Agent r/�j ,Signature Telephone No. 915 s 1 ` `01-1 PERMIT FEE: $ INSPECTION RECORD Date Notes — Remarks Insp 4 n e ! r