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Home My WebLink AboutMiscellaneous - 111 WOODCREST DRIVE 4/30/2018 (2)N MEN The Commonwealth of Massachusetts ""1te too Only DePcrtrnent of Public &fcry . r•r•4i so. r BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 occupaecv a roe owcmd r 3/90 (leave elan yev APPLICATION FOR PERMIT TO PERFORM ELECTRICAL NI work to a performed in accordance with the Mawchusena FJee:rieal Code, 5Z CMR 1COAL WORK (PLEASE PRINT IN nM OR TYPE Z 0F"'=ION) Date � �p City or Town of �[,� s To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street 6 Number) Owner or Tenant Owner's Address •V Is this permit in conjunction.. with a building permit: Yes C3no(Check Appropriate Box) Purpose of Building Utility Authorization NO. Existing Service_Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters' Service . Nev Se ps / Volts Overhead C3Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hoc Tubs No. of Transformers Total No. of Lighting Fixtures Above ❑ In- KVA Swimming Pool rnd.. No. of Receptacle Outlets rnd• ❑ Generators KVA No. of Oil Burners No. of Emergency Lighting No. of Switch Outlets U Bette Units No. of Cas Burners 7 ZO FIRA ALARMS No. of Zones No. of Ranges No. of Air Cond. local No. of Detection and cons Initiating Devices No. of Disposals No. of Heat Iotal Total P=vs KW No. of Sounding Devices No. of Dishwashers Space/Area Heating XW No. of Self Contained No. of Detection/Sounding Devices Dryers Heating Devices KW Local ❑ Municipal ❑ 0ther No. of Water Heaters KW No, of o, of Connection Si ns Ballasts Low Voltage Wirin No. Hydro Massage Tubs No. of Motors Total HP OITiERs INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts Ceneral Laws I have a current Lisbilit Insurance Policy including Completed erstio i. equivalent. YES E( NO I have submitted valid proof of same to this nOffice agYES LsNOu❑ tancial If you have checked YES, please indicate the type of coverage b check the appropriate box. INSURANCE t BOND ❑ =W(p (Please Specify) �Z �� Estimated Value of Electrical work S ration ace Work to Start Inspection Date Requested: Rough Final Signed under the enalties of perjury: FIRM NAME . ,� � �cEC T %� /c- ��/ 1 �- S 3 � Licensee LZC. NO.As %L% •T ✓Q �2 Signature Address. LIC: No. � 1YCi it � OWNER'S INSURANCE WAIVER; Alt. Tel. No. ` stantial equivalent as required byMassachusettsCeneralcensee doeVandot h��naChmyinsurance aignatureconethis por ermit sub application waives this requirement. Owner Agent (Please check one) Signature of er or Agent ?elephone No.. PERMIT FEE S Own 946 Date ............ . � �. ... NORTH .. TOWN OF NORTH ANDOVER k ! - y PERMIT FOR WIRING SSA US This certifies that ............ �.._.......... - ........ ....... has permission to per m ........... wiring in the building of .. ? :,,r.... at ..... . %...... ......... , North Andover, Mass. Fee../,.'5 ............ LiC. No,��... ..... .................... ...:.......................... ELECTRICAL INSPECTOR + g21/97 11:52 15, (H} PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer sw MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTI ' (Print or Type) C NORTH ANDOVER Mass. Date _ r building Location Permit "# Owners Name New '7a --"Renovation D Replacement Plans Submitted F1 YTI I =c (Print or Type) Check one: Certificate Installing Company Name `j'"— Cor p. Address �j Partner. Firm/Co. Business Telephone: Name of Licensed Plumber or Gas Fitter Insurance Covera e: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 'Other type of indemnity F__j 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 17 Agent E] i hereby certify that ail of the details and information I have submitted (or entered) in above application are true and accurate to the test of my knowtcdge and that ail plumbing work and installations petforated under' Permit isseed fo: this •ppLication�ill_be in compliance with all patlnent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. A By Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE: Plumber Gasfitter- G master Journeyman G Signature of Licensed Plumber or fitter N !cense Number Y • ■■ /M29100 ME WEE »»N»> ■SEAN MENNE NINKEt»EEMEME 000000000 son MEMENNEEMENN (Print or Type) Check one: Certificate Installing Company Name `j'"— Cor p. Address �j Partner. Firm/Co. Business Telephone: Name of Licensed Plumber or Gas Fitter Insurance Covera e: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 'Other type of indemnity F__j 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 17 Agent E] i hereby certify that ail of the details and information I have submitted (or entered) in above application are true and accurate to the test of my knowtcdge and that ail plumbing work and installations petforated under' Permit isseed fo: this •ppLication�ill_be in compliance with all patlnent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. A By Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE: Plumber Gasfitter- G master Journeyman G Signature of Licensed Plumber or fitter N !cense Number ,wy�wan�,;ewirlr..°a....� ...,_ _ _ _ .._ -. ,_ •�wia: ��..:e`wrtr;.'s.:,c.-,-,•. � ,;. �a r A: Date: ' �. _ 7 - 2534_ TOWN OF NORTH ANDOVER or 0� PERMIT FOR GAS'INSTALLATION Cn This certifies that /.:.. has permissionfor g gass i. tallation in the :buildings of ... ... ...... r North Andover, Mass. V: Yom` Fee .�'�'3..T.. `. . Lic. N ......... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK- Treasurer GOLD: File -6– 4—o-4 • •• aisesrtinan -^rr u%.,AI sun run f nnmi l s w uv f't.u�Yruu.v 0P11nt or Type) NORTH ANDOVER, . Mase. Oats :'/ .10� Building / Permit * j LOcatlon�/� Owner's Name New Renovation ❑ Replacement ❑ Plans Submitted: Yes ❑ No. ❑ FIXTURE$ Installing Company Address Business Telephone,, Name of Licensed Plumber uneclt one: ❑ Corp. ❑ Partnership E3+lrm/Co. INSURANCE COVERAGE: rchack one I have a current liability insurance policy or Its substantial equNWenL Yes ❑ No ❑ It you have checked y_". please Indicate the type coverage by checking the appropriate box I A liability Insurance policy IY— • Other type of Indemnity ❑ Bond Certwicate OWNER'S INSURANCE WAIVER: 1 am aware that the Ilcenies does not have the Insurance coverage required by Chapter 142 d the Maas. General Laws. and that my signature on We permit application waives this requirement. Check one: Signature a er or O*ner s Agent Owner ❑ Agent ❑ I hereby c«uty that all o1 the details and Information I have a Am"ed tor. enlsredl b above application are true and aoeurals to the best of my lnowted�e and that ata plumbing work and installations performed under the p tml! laausd for this appffca wife fn eompNance with all pertinen provhlons of the Masuchuretts State Plumbing Code and Chapter 1j2 al l.arw. This 8grAturs of LicensedPlumber City/Town Lksnse Number APP110VED (OFFICE USE ONLY) Type of Plumbing License: Master 0 Journeyman �� on ONE Installing Company Address Business Telephone,, Name of Licensed Plumber uneclt one: ❑ Corp. ❑ Partnership E3+lrm/Co. INSURANCE COVERAGE: rchack one I have a current liability insurance policy or Its substantial equNWenL Yes ❑ No ❑ It you have checked y_". please Indicate the type coverage by checking the appropriate box I A liability Insurance policy IY— • Other type of Indemnity ❑ Bond Certwicate OWNER'S INSURANCE WAIVER: 1 am aware that the Ilcenies does not have the Insurance coverage required by Chapter 142 d the Maas. General Laws. and that my signature on We permit application waives this requirement. Check one: Signature a er or O*ner s Agent Owner ❑ Agent ❑ I hereby c«uty that all o1 the details and Information I have a Am"ed tor. enlsredl b above application are true and aoeurals to the best of my lnowted�e and that ata plumbing work and installations performed under the p tml! laausd for this appffca wife fn eompNance with all pertinen provhlons of the Masuchuretts State Plumbing Code and Chapter 1j2 al l.arw. This 8grAturs of LicensedPlumber City/Town Lksnse Number APP110VED (OFFICE USE ONLY) Type of Plumbing License: Master 0 Journeyman �� t}�'st'+r'�T:4^yy;,�';7:-art.;' . aim -e—_ �"t. �.,v�f .,,�. �_ _�,�. '-�w,.� .G_,..r-' - .,. „s,=✓n {�;—�-'-N..;,N••�,+- k ' ` 3-335 c�� J Date.. 3- 3:- A NOR7M .. �',. •'�c TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACNUS� / C This certifies that ... . . has permission to perform ...... �V..:. _. plumbing in t} e'buildings of .. . �t. ...................... at ... ait/ �� . !1 ?:.. , North Andover,. Mass. . -4... 1&.3.vo Fee. �. Lic. No.. ........................... . PLUMBING INSPECTOR C- 0 WHITE,, Applicant CANARY:.,Building Dept. PINK: Treasurer NORTH ANDOVER BUILDING DEPARTMENT 400 Osgood Street Tel:. 978-688-9545 Fax: 978-688-9542 BUSINESS FORM FOR TOWN CLERK DATE: �' I NAME: ADDRESS: t I �C� Cid ZONING DISTRICT: TYPE OF BUSINESS: BUILDING LAYOUT PROVIDED: YES NO AVAILABLE PARKING SPACES:'-� ZONING BY LAW USAGE: 4S NO BUILDING INSPECTOR SIGNATURE Rev6M 11.5.04 $USINFSSFORM FOR TOWN CLERK �-) �,