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HomeMy WebLinkAboutMiscellaneous - 1060 OSGOOD STREET 4/30/2018 (20) i , � I I �� i � � �, � � �'� �o/ i \ crTab® Oversized-Tab Folders 90%Larger Label Area MIEAdl KEEPING YOU ORGANIZED No. 10301 PATENT PENDING wFOREa�RY 11,111N.RE IPIITWTVE CONTENT 10'K POSTCONSUMER aaoisco MADE IN USA GET ORGANIZED AT SMEAD.COM Date. ?.... .. .. TM Of o? '' ° TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION SACHUSEtS - This certifies that 1;17/ . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . .r`. `' � '�. �. . . . . . . . . . . . in the buildings of . . r—0. . � '4. . l� h. . :. . . . . . . . . . . . at .A?:e<<. F.,/ . . . . . . . . . . . . . . . . North Andover, Mass. Fee. .).). . . . . Lic. No..:. !.?. . . . . . .v... . . . . . ��� (SAS INSPECTOR Check# 3 � u MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) _ Mass. Date r�✓ 19 Permit # 1�61 it L ' Building Location \CS�a� �SyS�� �wner's Name of Occupancy �H New ❑ Renovation ❑ Replacement Plans Submitted: Yesp No N Q N W N Y z Q y F- 0 Uj Q m N h y O W 0 d C < UjCrN rt cc W x 4u yr vy W W h W W J H Z y W W Q O > LL h W J h W Z s W J < ~CC UJI < < O O W a O W F- < W i C7 = 4. Q C J U C Y G 6 O C •S O SUB—BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR y 4TH FLOOR STH FLOOR 6TH FLOOR 7TK FLOOR 8TH FLOOR Installing Company Name MILNE PI ar; R IiTNQheck one: Cert�c ate '0 BOX 603 Address Corporation p.IeV�STER MA 01944 Partnership Business Telephone �� �J�—� �j ❑ Firm/Co. Name of Licensed Plumber or.Gas Fitter INSURANCE COVERAGE: I have a current I' rty insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked Les, please Indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity❑ Bond ❑ 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. Che one: _ Owner Agent p Signature of Owner or Owner's Agent 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 under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State.Gas Code and Chapter 142 of the Ge eral s BY. . ` T55urneyman um f license:. ber Signature.of Licensed Plumber or Gas Fitter Title er ster License Number City/Town r APPRCNED l0 IC S. NL w n Date..... '.. .. '. ..... gORT" °ft"`°�•�"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING �SSACMUS� This certifies that .....................................................TY .. ..................................... has permission to perform ..........5.�:. Y..... .US�.F ,,00 wiring in the building of... SU . �R FU+i L6,vvS�Lra .................... .............................................. �D60 dv©- at................................... ........Q.. ....S.l................ ,North Andover,Mass. Fee.. Lic.No.... ..... ........................ 9306 0 E[.ecrxicu.IxsPecrox � Check # 407/ 3& 6 (. 6 J � 1 Commonwealth of Massachusetts Official Use Only 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(MEC) 527 CNiR 12.00 (PLEASE PRINT IN 1NK OR TYPE ALL INFORMATION) Date: �—� (� City or Town of: �J, �-✓��G v Lr 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) n(00 900C( Owner or Tenant (2dVjS vvvleA Gircc( 4� CO vyt Se (t,Vt S Telephone �6 Owner's Address Is this permit ill conjunction with n 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 ❑ Und rd g ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: S•�.g\.q,vA_ Com letion of diefolloiving table may be waived by the Inspector of(Vires. No. of Recesses! Lurninaires No.of Ceil.-Sus?.(Paddle) Fans No. of Total Transformers i�VA _ No. of Lurriinaire Outsets No. of(lot Tubs Generators KVA. Above In- o. o EmergencyLighting No. of Luminaires Swimming fool rnd ❑ . rnd: ❑. Ba-ttery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection and InitiatingTotaDevices No. of Ranges No. of Air Cond. Tons l No. of Alerting Devices Beat 1 urn Number 'tons K No. of Waste Disposers o. of Self-Contained Totals """"""""" Detection/Alerth Devices No. of Dishwashers Space/Arca Heating KW Local❑ Municipal ❑ Other Connection No. of Dryers [-seating Appliances KW Security Systems:* No. of Devices or Equivalent i IVO. A;W ;i I . V. NCv. v_ aia `di':w ng: Beaters Signs Ballasts II No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: �- No.of Devices or Equivalent OTHER: A ttaclr additional detail if desired, oras required by the lns.o ctor of 11'it- Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: As n P Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE, COVERAGE: Uniess 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 cff;c.e. CHECK ONE: INSURANCE Z BOND ❑ - OTHER ❑ (Specify:) 1 certify, under the Pains and penalties of perjury,that the infornrption on this application is trite and complete. FiRM NAME: ADT Security Services, inc. LIC. NO.: 1533 C ' Licensee: 'DOUG BUCKERiDGE Sign IlitC . LIC. NO.: 2306D WAP (If applicable, enter "exempt"in the license number line.) Address: 18 CLINTON DRIVE HOLLIS N .H. 03049 Bus. Tel. No.:. .r 03.594-5900 _ _ Alt. Tel. No.: 3-594.593 6Q _ *Security System Contractor License required for this work; if applicable, enter the license number here: SS CC 001594 OWNER'S INSURANCE WAIVER: _t am aware that the Licensee does not have the I'iability insurance coverage normally required by law. By my?denature below, i hereby waive Qiis requirement. i am the(check one)❑ owner owner's ager;t. Owner/Agent (—"-- --� Signature — _--- Telephone No. j PERMIT FI F: I