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HomeMy WebLinkAboutMiscellaneous - 10 BRIARWOOD COURT 4/30/2018L NORTH L �,SSACNUSE� Date. ...........'q...... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ......4..° . I. -:,.� ......... has permission for gas installations -t:! : !: :...°:.. ... . in the buildings of,. ec..e.. �/ ... . .G 7t e at /U..�............ `North Andover, Mass. Fee. '. . Lic. No..`..r ei� 3�r....... . GAS INSF�� Check # a 6350 F MASSACHUSETTS UNNORMAPPUCATONFOR PERM TO DO GAS FfrnNG (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations A9 U/, /�1` �w err, m� �' �:, % Permit Amount $ c� Owner's Name New Renovation Replacement ©/� Pians Submitted UB-BASEM ENT ASEM ENT ST. FLOOR ND. FLOOR RD. TH. FLOOR FLOOR TH. FLOOR TH. FLOOR TH. TH. FLOOR FLOOR U Z F x w C a w dF e x Z, 4 w > w a UB-BASEM ENT ASEM ENT ST. FLOOR ND. FLOOR RD. TH. FLOOR FLOOR TH. FLOOR TH. FLOOR TH. TH. FLOOR FLOOR (Print or type) Address usmess Name of Licensed Plumber'or Gas Fitter ,'hrdCk one: Certificate Installing Company Corp. Partner. Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance, policy or it's substantial equivalent. Yes �� NoO If you have checked Vis, please indica he type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity D Bond 13 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 13 Agent 13 I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed�nd it Issued for this ppli n will be in compliance with all pertinent provisions of the Massachusetts State Gas a ter 1 P �2ffie ne aws. By: Title IAPPROVED (OFFICE USE ONLY) Signature of Licensed Plumber ir)'i Gas Fitter Plumber Gas Fitter kens u er rl Master urneyman c w rA O Q U Z F C > dF C ,'hrdCk one: Certificate Installing Company Corp. Partner. Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance, policy or it's substantial equivalent. Yes �� NoO If you have checked Vis, please indica he type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity D Bond 13 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 13 Agent 13 I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed�nd it Issued for this ppli n will be in compliance with all pertinent provisions of the Massachusetts State Gas a ter 1 P �2ffie ne aws. By: Title IAPPROVED (OFFICE USE ONLY) Signature of Licensed Plumber ir)'i Gas Fitter Plumber Gas Fitter kens u er rl Master urneyman s r Commonwealth of ill'assaehusetts Official Use Only -^ Department of Fire Services Permit No. —4-2-3— BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked [Rev. 9/051 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 INFORIIIATIOIV) Date:_ a /7,/o City or Town of: _ tiV. ,?j,,,� We^ 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 & Number) ,0'/0 2 t A Owner or Tenant (, ,Jr (. t 4 �� C ,;:.J , � Telephone No. Owner's Address fir► G Is this permit in conjunction with a building permit? Yes . No ❑ (Check Appropriate Box) Purpose of Building Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Utility Authorization No. Overhead ❑,I Undgrd ❑ No. of Meters Overhead ❑ Undgrd ❑ No. of Meters Location and Nature of Proposed Electrical Work: i ,�. jt A,4 fu C:.vd, No. of Recessed Luminaires -- -.. ...� �..�..... No, of Ceil: Susp. (Paddle) Fans ..., .� ...N — Waive" o tine j� ecwr o rrtres. o. °f Tota Transformers KVA No. of Luminyire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above [-]—In- ❑ rnd. rnd. o. o Emergency Lighting Batteg Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiatine Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat ump Totals: umber I Yons I r No. o e - ontame Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑Other Connection No. of Dryers No. o. of ea KW Heaters Heating Appliances Kit No. of NO, of Signs Ballasts Securityf Dena s or Equivalent Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP a ecomm Devices o r Equivalent No. of Devices or E uivalent OTHER: r Attach additional detail if desired, or as required by the Inspettor of Wires. Estimated Value of Electrical Work:" UO (-When required by municipal policy.) f Work to Start: i / / / f(J) < Inspections to be requested 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. FIIuvI NAME: T a 7 t'—I , ,^, t. C tX.q r .c 14,- l' t LIC. NO.- _/) Y i Z A Licensee: � , -I o i —rV h :-2.., Signature ,,' s ^ -^—s�� LIC. NO.:3 y Y.t u (If applicable, enter "exempt " in the license number line) C Bus. Tel. No.: %� 'L irl ' ?_ %✓" Address: �t_ U i3 ft,d 5 ; r"� 1 yf,1 Alt. Tel. No.:;/Jr *Security System Contractor License required for this work; if applicable, enter the license number here: OWNER'S 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. I am the (checCk one) ❑ owner ❑ o�kmer's agent. O}N ner/Abent Signature Telephone No.PERR'fIT FEE: $ 6193 5 Date.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... j7;�T ..ZlAtop . .......................................................... has permission to perform ..... R. I .... t0,d F.,,,,,,,, wiring in the building of ...... wpoo 1218 f .... 6�.S .......................... 0 .......... .............. at ........... 16 '81 ..................... �.,! ��W. !ZV D .................... . North Andover, Mass. Fee..3.0:7;;?7 Lic. No. .............. Ii AL INSPECTOR Check # ELEag Official Use Only Commonwealth of Massachusetts (" L— Department of Fire Services Permit No. � Occupancy and Fee Checked , BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEG), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATI019 Date: /117,10 i City or Town of: /`r►. A;vb Ove Y -L 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 & Number) &a t Art W ooa Owner or Tenant Telephone No. Owner's Address S Qn Q - Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Existing Service Amps New Service Amps Number of Feeders and Ampacity Volts Volts Utility Authorization No. Overhead ❑I Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Location and Nature of Proposed Electrical Work: �( l -`fir, p A �D QQ c- Add ---i `Tr0 C-0 de ' Comnletion afthe fnllnwinv tnhlp mnu hp wnivpd h„ the lnv—inr nrWi— No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans o. of Tota Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires A Swimming Pool ove ❑ n- E] rnd. grnd. No. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners !To -. —o7 Detection and Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers HeatPump Totals: I Number ITons o. of el - ontame Detection/Aler ng Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal11 Other Connection No. of Dryers Heating Appliances KW ecurity Systems:* No. of Devices or Equivalent No. of Water Heaters KW o. of _ o No. Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP a ecommumcationsWiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: () b (When required by municipal policy.) Work to Start: r1 l t % K Inspections to be requested 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 cover a 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 ofperjury, that the information on this application is true and complete. FIRM NAME: p 7 e- i w G L e Cr -4Z. A,1L . LIC. NO.: -2y � 2 A Licensee: z �-) "N it -X , Signature LIC. NO.:3 t S/S o E (If applicable, enter "exempt " in the license number line.) _ Bus. Tel. No.: ?�''C.�L ' FT Address: /10 Re�llxak 11,sre,� Alt. Tel. 5- *Security System Contractor License required for this work; if applicable, enter the license number here: OWNER'S 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. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE. $ Signature Telephone No.