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HomeMy WebLinkAboutMiscellaneous - 11 RICHARDSON AVENUE 4/30/2018 11 RICHARDSON AVENUE 210103 0000'0 J f I NORTH °`t„`°;•1"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING � O p • i _ i ;,SSACMUSE� This certifies that-,:...... ........ ................... .... ................................ has permission to perform _--.. ........... wiring in the building of .........:..................... ...................................... at..��!.__..� --{..! ��` -� — 1 North Andover Mass. Fee`�.....!. �....... Lic.No.1 �t5-fX .. -...'.:�. ... . .. .. ...... ELECTRICAL INSPECTOR Check # 7045 Commonwealth of Massachusetts Official Use only Permit No. Zo—V,- '— Department of Fire Services' —00 Occupancy and Fee Checked�J `—' Q 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(M C),527 MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: JJ 70,- City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives otice of his or her intention to perform the electrical work described below. Location(Street& Number) /171�'/.�,4 n 5-PAl �t/,�' Owner or Tenant ,y UZ t Z Telephone No. Owner's Address l// Is this permit in conjun tion with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building [�jQ�,(/jj�1,L Utility Authorization No. Existing Service d Amps lgp Volts Overhead © Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location an Nature of Proposed Electrical Work: /1�7`��F.� �f E/yDIJF_,L r./�G,PL-,9 S Sz f Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 9 No.of Hot Tubs Generators KVA No.of Luminaires p' Swimming Pool Above ❑ In- ❑ o.o Emergency Lighting rnd. rnd. Battery 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No. of Waste Disposers Heat Pump I Number I Tons I 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 KW Security Systems:* No.of Devices or Equivalent No..of Water KW No.o No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: , No.of Devices or Equivalent OTHER: tiAttach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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 P BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: �)7C ,(�G j/L LIC. NO.: Licensee: C Q Signature LIC. NO.:J 6i 15-3 `{ (Ifapplicable, enter 'exempt"in the huense number jie.� Bus.Tel. No. 78'3��'Te�i� Address: C E y r SS 0 yf �' Alt.Tel. No.: *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 ERMIT FEE: $ Signature Telephone No. FP �-'' Date. J �. . "ORT" TOWN OF NORTH ANDOVER PERMIT FOR P MBING SACMUSE� This certifies that . . . . . . . . . . . . . . . . . . . has permission to perform . . .Li. .1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . (. .14 " '. . . . • • . • • • • • • • • at . . . .. . . . . . . . . .. North Andover, Mass. Fee. . Lic. No..���.5.`: . . . . . . . . . . .�-r�^-.--�„r-'r-. . . . . . . / PLUMBING INSPECTOR Check # 7171 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date / (� � //�� r , � Z3� Building Location l j V-1 C AAft n5a 40 C Owners Name J I M I G 1 rrA S Permit# '��'� l t,1_2 Amount w Type of Occupancy eb✓f New Renovation 0 Replacement Plans Submitted Yes No El FIXTURES H � W � A H � SLBHgVIC 1S'Ir HfM M Flf= 3MHfm 4IH FIRM 5M FLOCK 6M HDM 7IH FLOQt SIH HDD HER I I I (Print or type) Check on Certificate InstallmiCompany Name �ag& pl., 0 Corp. Address v 0 Partner. -r/", Business Telephone �"9 k 6"g S— 3/ 3'3 ® Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy l Other type of indemnity 11 Bond ❑ insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner El 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 Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus tat Code , d Chapter 142 of the General Laws. By: SIgnaWte 01 LICenSeaum er Type of Plumbing License Title L 3 q City/Town APRicense NumDer Master tj Journeyman APPROVED(OFFICE USE ONLY f Date-"r.�l/. .` .�1�. . . ... . . 40RTry o� TOWN" NORTH ANDOVER PERMIT FOR GAS INSTALLATION �9SS�CMUSEtt This certifies that . . . ..f'/. . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . . . in the buildings of . . . .... . . . . . . . . . . . . . . . . . . . . . . . at . . . /./. . A !( r. .r. .: . . . . . . . . . . . .. North Andover, Mass. Fee. )n.�. Lic. No../A S Y. . . . . . . . :. GASINSPECTOR Check# O 5787 RASSACHUSETTS UNUDRM APPUCATON FOR PERNIlT TO DO GAS F ING (Type or print) Date NORTH ANDOVER,MASSACHUSETTS ,( �+ Building Locations ` I C� °AI. Oso )y 17P L, Permit# S^�v 2 Amount$ 3p Owner's Name -j� J F S New Renovation Replacement Plans Submitted ❑ � w 4, ",- U z z Gr~ W E- x za e a a w C a w E. w E" a H z H w w � w rA U god SUB -BASEM ENT BASEMENT 1ST . FLOOR 2ND . FLOOR 3 R D . F L O O R 4 T H . F L O O R E7T . FL O OR . FLOOR . F L OO R . FLOOR (Print or type) �' / Ch��c one: Certificate Installing Company Name l �/ ��� ElD ff Corp. Address U ❑ Partner. ni Business a ep one _ ` Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 0 No O If you have checked yes,please indicate the type coverage by checking the appropriate box. Liability insurance policy M Other type of indemnity M 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. Check one: Signature of Owner or Owner's Agent Owner 13 Agent hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the hest of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the !Massachusetts State s C e and Ch' ter 142 of he General Laws. By: S'gnature of Licensed Plumber Or Gas Fitter 'Title: Plumber 136 of z City/Town Gas Fitter7-cense iNUMFer ® Master APPROVED(OFFICE USE ONLY) � Journeyman