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HomeMy WebLinkAboutMiscellaneous - 111 MILLPOND 4/30/2018 J111 MILLPOND 210/095.A-01 11-0000.0 1 RIMEMENNEM 7348 Date. . �. ��1�....... Of ,SORT" 1ti 0_ TOWN OF NORTH ANDOVER o PERMIT FOR GAS INSTALLATION �9SSACMUSEt �V This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . .-.r. . . . . . . . . . . in the buildings of . . . . . . . . . at . .���. . . � .C. ,l.�U. . . . . . , North Andover, Mass. Fee. .30. Lic. No../, �. . . .GAS I�CTOR Check# 27 i NLASSACHliSUM LT�HbRNI APPUCATON FOR PERtNIlT TO DO GAS (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations /I phi//pd/up Permit# 3 �� Amount Owner's Name !�U /—r New Renovation ❑ Replacement r7j-**� Plans Submitted ❑ w `7 H F q x a o w x z O 4 w C4 F O M-4 a F O W cy�� 7' F. U H Z Z H W cpq > W U F a� O 0 W 3 A U ,.a UG x > A H C SUB -BASEMEN T B A S E M ENT 1ST. FLOOR 2ND . F L O O R 3RD. FLOOR 4T 1I . F L O O R 5 T H . F L O O R 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) l ,r / / Check one: CertificateInstallingCompany Name l' �� /Y'ij--� �N—L7� /�1 (� rp. cl;?, /1 Address �� l� lr 1-h0/U� S� ✓_ O ( S Partner.. Business'Telephone Firm/Co. Narne of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes E No o If you have checked M,please indicate the type coverage by checking theappropriate box. �. 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 1.12 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 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- hcSt of my knowledge and that all plumbing work and installations lcrf rrjl(:!d tinder Permit Issued FOC this application will be in compliance with all pertinent provisions of the Massachusetts Stat (; 'od and C hapten 14'7 of the General Laws. By: Signa[ re -iccnscd Plur i cLOr Gas Fittcr Title Plumber CityiTown [D Gas Fitter License um er tester \PPROVED('OFFICE USE ONLY) Journeyman Date. . /.. . .. . . . . . . .. . .. . TIy Of HOR1ti 3? �` TOWN OF NORTH ANDOVER PERMIT FOR CAS INSTALLATION h .t -�9SSACMUSESS This certifies that . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . .6a. in the buildings of . . .Z e . . . ! 0... . . . . . . . . . . . . . . . at . . . . . .l. . . ?. . . . . . . . . . . . . . . .. North 0,10 dover, Mass. Fee. . . 6©. . Lic. No..103,90. ! GAS INSPEC 'OR Check# p�S 4133 MASSACHUSETTS UNII+ORM APPLICATON FOR PERMIT TO DO GAS F1ITIlVG ' (Type or print) Date NORTH ANDOVER,,MASSACHUSETTS Building Locations 7// / '< Permit# Amount$ Owner's Name New Er� Renovation 0 Replacement 0 Plans Suba Q O � SUB-BASEM ENT BASEMENT 1ST. FLOOR ZND. FLOOR IRD. FLOOR TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7 7TH. FLOOR 8TH. FLOOR (tet ort3'! ) +. / one: Certificate Installing Company Name Corp. 0 Partner. - Business Telephone Fiini/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability.Insurance pol or it's subI .stantial.equivaient Yes Noo Ifyou have checked 11 . 11 Xes,-,please; - the.type c overage by checking the appropriate bax: Liability insurance policy Other type of indemnity 0 Band 0 Owner's Insurance Waiver- I amaware that the licensee does not have.the Insurance coverage required by Chapter 142 ofthe Klass. erA Laws,:and_that my signature On:this:peamitapplication waives this mp iremei L, Ch edc vile: ignatute ofOwner or Owner's Agent Owner Agent Q I h yac ertify that all ofthe details and information I have submitted(or entea+6d)in above application am true and accurate to the best of my-knowledge and that all plumbing work and in' ati performed under Permit_Issued for this application licaton will be in i compliance with all pertinent provisions ofthe Massac etts to C and er 142,Af General Laws. Si of Licensed Plumber Or Gas Fitter Title lumber l � City/Town Gas Fi er Icense Number aster APPROVED(OFFICE USE ONLY) � Journeyman 2� �D y a MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO 00 GASFt tNG (Print or Type) t NORTH ANDOVER Mass. Date G1 kuilding Location /// /"//l��D�S/� Permit #4G7y .� Owners Name lole'o ? - New '7 RenovationReplacement Plans Submitted D FIXTUP=Is N W N z = v, NQ N C .O O N S i- W W m m a o to r F z N a 4 G1 A. � ad n i us � V > W (n W N a f O c W .. �t�qto- LU W W O O ? U. !w- V Cl us Q 2 d W J < a f' �- N m O z W d N = d W > C W O z 4 tt d Q O O W 5 O W I— a =1 O u. n O v c= > ci a h- o SUZY—BSVIT. t BASEMENIT 1 IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR TTH FLOOR BTH FLOOR (Print or Type) /' Check one: Certificate Installing Company,,fName (f/ Corp. Address I /y - T = Partner. .¢tG1 Firm/Co. Business Telephone: n �z ®/?' Name of Licensed Plumber or Gas Fitter 7 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 0 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 coverages. Signature of owner/agent of property Owner 1:1 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 aU plumbing Work and installations performed under Permit iuLed for this application will-be In compliance with all pertinent provisions of the Massachusetts State Car Code and chapter 142 of tho Genera!Laws, By TYPE LICENSE: Plumber Title G sfitter Signature of Licensed City/Town: aster Plumber or Gasfitter Journeyman ll�7 APPROVED (OFFICE USE ONLY) Lion Number Office Use Only - uhP �nmmunwettlfhttnntttlun� s Permit No. s ? +4eparimmt of Public —Aafetu Occupancy&Fee Checked /5 r r� 3/90 (leave blank) BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date .�2—G- OM or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work�described below. Location (Street & Number) �� m L L Po P1 Al `S! 41L Owner or Tenant �— Owner's Address S m Is this permit ;n conjunction with a building permit: Yes No l (Check Appropriate Box) Purcose of Eulicino Utility Authorization No. Existinc Service Amos _J Volts Overhead Undgrnd r❑ No. of Meters Ne:v� Seriice Amps —__JVolts Overhead E, Undgrnd C No. of Meters Numcer of Feecers and Ampacity Location and Nature of Proposed Electrical Work Total No. of L:cnunc Oucets No. of Hot Tubs / I No. of Transformers KVA j Abover--, In- � No. tic^Dna F:.tures Swimming Pool KVA j grnd. grnd. Generators No. of Emergency Lighting No. of Receotac:e Cutlets No. of Oil Burners Battery Units No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones Total No. Detection and No. of Ranges I No. of Air Cond. tons Initiais ting Devices Heat Total Total No. cf Discosa;s No.of Pumos Tons KW No. of Sounding Devices No. Self Contained No. of Disn.vasners ; Space/Area Heating KW Detection/Sounding ction/Sounding Devices — MunicicaiOther No. of Driers I Heating Devices KW Locai Connection i No. of No. of Low Voltage No. of Water Heaters KW j Signs Bailasts Wiring 'Jo. -,Vcro '.tassace -ubs No. of Motors Total HP OTHE . INSURANCE COVERAGE. Pursuant :o the requirements of Massachusetts ..neral Laws � _ 1 have a current Liaoiiity Insurance Policy including Comoietea Operations Coverage or its substantial equivalent. YES ✓ NO h — ave sucmrttee vaud oroof of same to the Office. YES = NO — If you have checked YES. please indicate the type of coverage by C r�eCKinQ me aocr orate oox. INSURANCE 30ND = OTHER = (Please Soec.fy) (Expiration Date) Esrm,aied `Jalue of Eiec tical Work S 00 �� i Q 'Mork ;o Start — nsciection Date Recuestee: Rough C� / Final Sioneo under ;tie Penalties of perlury: J-R al U ya FIRM NAME V L pp LIC. NO. PSL}y L 3 K J�yf n b )' T�\ Signature LIC. NO. _cense. >� S p g L yy Bus. TeI. No. Address n ��/ �' S 7— �Yl �=T �/ E " " / / Alt. TeI. No. OWNERS INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- cuirpc by Massachusetts General Laws, and that my signature on this permit aopiication waives this requirement. Ow Agent ,Please checK ones Telephone No. PERMIT FEES v :Slonature of Owner or Agent) 7 Date...... . ... 2037 ..... NORTH 0 •4, - TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING C" This certifies that ..................... ...:r>'4............ .......... has permission to perform ..... ......................... wiring in the building of..........h/... .. ....... ..................................... .... ... at........t'11... t- 1r/A ...... . ........ ..................... .North Andover,Mass. Fee....... . .k . Lic.No...t.!. ..`. ............................................................... ELECTRICAL INSPECTOR 0V06/95 13:27 WHITE: Applicant CANARY:Tu ildffllgept. PINK:Treasurer GOLD: File r� t Office Use Only 014f 0011IMp11WE81 lj of _4HU00 14USetts Permit No. `/ �rlrn -ttrimt of Public nfetq Occupancy& Fee Checked �J 3190 (leave blank) BOARD OF FIRE PREVENTION REGULATIONS 521 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12: (PLEASE PRINT IN INK ORT E AL INFORMATION) Date %)V or Town of_ __ �L�!/-�/7 To the Inst, for Wires: The udersigned applies for a permit to perform the electrical work described below.Number 7,#& Location (Street & ) �`z/� /—_�� Owner or Tenant Owner's Address ��r�/I ���� lt!1 -�, ��___— `-6 2 '1 i permit: Yes ' No ❑ Check Appropriate Box) Is this permit in conjunction with a building ng pe ( Purpose of Building �,. Utility Authorization No. Existing Service OD Amps 22-0 -;)OFVolts Overhead ❑ Undgrnd [9 No. of Meters New Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity — Location and Nature of Propo Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners I Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Tot ototal No. of Detection and ns Initiating Devices No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices No. of Dryers Heating Devices KW LocalMunicipal [J Other ❑ Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP I - A OTHER: IN URANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws 1 have a current Liability Insurance Policy Including Comd Operations Coverage or its substantial equivalent. YES �O 7: 1 have submitted valid proof of same to the Office. YES ple NO C If yo.uhave the ke YES, please indicate the type of co rage by checking theappropriate box. INSURANCE PS, BOND C OTHER G (Please Specify) v (Ex ration Datel Estimated Value of Eie tr(cal Work S Work to Start Inspection Date Requested: Rough Final Signed under the P s of perlu . 1 FIRM NAME LIC. NO. —6 Licensee Signature LIC. I r Bus. Tel, No. Address -Alf. Tel. fJo. OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the insure ce coverage or Its substantial equivalent as r - G p r e by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent lease check one) /� " Telephone No. PERMIT FEE S -7[(, tSignature of Owner or Agentt r.fiSFS Date.... 2325 + . ... S NORTH ti�L TOWN OF NORTH ANDOVER ° p PERMIT FOR WIRING ,SSA USEt . f This certifies that ......... .r.. ... ... ......l.....Pt,....1.'' has permission to perform ............r..f..:�......... .F....... :...". :................. ryry wiring in the building of ... .......�...L.. ..... � �'�°Y rr+ tf at....... ..,:-7?.�y.........# . f. t, �s r...................... .North Andover,Mass. F ., J t/. Lic. Noft"�y4:•, __ ....................................... } ELECTRICAL INSPECTOR PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File Date. ... . ........ ,,01tTN TOWN OF NORTH ANDOVER 6 0 PERMIT FOR GAS INSTALLATION SACH S This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . . in the buildings of x . . . . . . . . . . . . . . . . . . . . . . . . . . . . at .. . . .... . . . . . . . . . . . . . ... . . . . . . . . . . .I North Andover, Mass. Fee. . . . . Lic. No.. .'. . . . . . . . . . . . . ; ... . . . ... . . . . . . . . . 15.0@ASPPADIECTOR /94 OB-43 I WHITE:Applicant IURRY: Building Dept. PINK:Treasurer GOLD: File