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HomeMy WebLinkAboutMiscellaneous - 115 COLONIAL AVENUE 4/30/2018 (2) 115 COLONIAL AVENUE / 210/107.8-0129-0000.0 Date. ). . ... .. .. OF HORTh 1H o� °` OWN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION f. SSACMUSES This certifies that . . -f . . .t,+ .!�. . . . . . . . . . . . . . . . . . . has permission for gas installation C'0�!f . .C!! :./.'. !':. . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . at j-. . .Cc r :7, . , North Andover, Mass. Fee. ?. : ' . Lic. No.��}:�. . . . . �"'. . . . . . . . . . . GAS INSPECT Check# /I 53 ,1E MASS APPROVAL # MASSACHUSETTS UNIFORM APPLICATION FOR PERMITTOM GASFITTING (Print or Type) fihi.oUE/z-- Mass. Date Permit# jLn'^1 Building t ocation 4 COLO 1�/i'� J .owne.•s Name .1 O['T L C—19APj _. Typed Occupaney1 C New 0 Renovation Replacement❑ Plans Submitted: Yes❑ No a e: � W a Y a � _ rt n N C N s 0 e1 = F W W W tA. .iC O V Ol f' J W h• Z 0 C tt m W < 7, a �. N e. a: � < p O = O mY W WJ 'A W rI- zozro c 'i o o Ic c d v ¢ .> 0 d 1w- o sun—BsraT. BASEMENT 1sT FLOOR 2ND FLOOR G1 I *RD FLOOR _ -C 4TH FLOOR 5tH FLOOR 6TH FLOOR < TTH FLOOR `TH FLOOR Installing Company Name YANKEE GAS ' Check one: Certificate Address 140 SOUTH MAIN STREET Q Corporation 103C MIDDLETON, MA 01949 [. Partnership Business Telephone 978-774-2760 = Firm/Co, Name of Licensed Plumber.or.Gas Filter WILLIAM R. CHAR R T S INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 13 No O If you have.checked yes. please Indicate the type coverage by checking the appropriate box A liability Insurance policy 13 Other type of indemnity 0 Bond 0 OWNER'S INSURANCE WAIVER: I am aware that the licensee does nct 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: Owner) Agent O Signature or Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(or entered)in above=4caticn area and accurate to the best or my •knowledge and that all plumbing work and installations performed under ow pe for oris with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 at 1M Lz fjy TjPG', .'t�-,,', of Lcense: umgnatuie o cermseC mbar or iter TAW Master License Number 3785 Oty/Town journeyman NC • ./...31.91- � * Date........_,.. NORTH Of t.�ao ,•1ti TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHUS This certifies that .... ......../ CJ�1�P......✓.P...................... has permission to perform ..... .14?.<.1.tyl..........C. 5.......................... �, �, U.L winhg in the building of.........�.... l............................................................. n� /'r).., a / d rth Andov . ,� ��y Y� Fee.... . ........ Lic.No./rs. k1 . .................. ...... .. ............1/................ LE RICAL INSPECTOR Check # Commonwealth of Massachusetts Urriciul U.c 0111y Department of Fire Services kv Pcrmit No. BOARD OF FIRE PREVENTION REGULATIONS Occupuncy acid 1-ce Checked Rev. l 1/99 I�.;,vc bl:uik APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Aft work Io he Perfitnned in accordauee with the Massachusetts Electrical (:odc(MIX). i27 CM1Z 12.00 _ WI,EASE PRINT IN INK OR TYP ALL INFORMATION) Date: Ciiy ur Town of: _ J �/j//�G/� Z By this application the undersigned gives notice his or her Intention to Pe forTo /m the elects che tal w�r�described below. Location (Street & Number) Owner or Tenant L Owner's Address Telephone N0. Is this permit in conjunction with a building perinit? Yes ❑ No Purpose of Building (CheckAppropriate Box) Utility Authorizatiort No. Existing Service Amps / _Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amos / _Volts Overhead ❑ d6 Lnr'd No. o ❑ — Number of Feeders and Arnpacity c C Milers Locationland Nature of Proposed Electrical Work: i Com letian o tlte ollowin table may be waived by the Irisctorotal u Wires. No. of Recessed Fixtures - No.of Ceil.-Susp.(Paddle) Fans V. ° No. of Lighting Outlets No. of Hal Tubs Transformers KVA Generators I<VA No. or Lighting FixturesSwimming Pool o ove it 0. 0 rnergency ig t Eng rttd. 11r1 11Batter Units No. of Receptacle Outlets No.of Oil Burners FIIJE ALARMS No. of Zones No. oCSwitchcs No. of Cas Burners 0- 0 etection an No.of Ranges No. of Air Cond. Dial Initiatifiv, Devices Tons No. of Alerting Devices No. of Waste Disposers cat utnp um-er ons Totals: --- -- ........_- --- o. o Sc f- ontatncd Detection/Alertin Devices No. of Dishwashers Space/Area Heating KW local unicipa t10tt � Other No. of Dryers Heating Appliances Kms, ccurity ' ste o- o "ter 1V vices or E uivalcut Heaters KW °' ° t o.as Data Wiring: SI us Ballasts No.of Devices or Equivalent No. Hydromassageht ,h No. of Motors Total HP elecomtnunications tring: No.of Devices or Equiv3rent OTHER: Attach additional detail of desired, or as required by the Inspector of Wires. 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. Tte undersigned certifies rltat such covetagc is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ 01-HER ❑ (Specify Estimated Value of Electrical Work: (l;xpintion Datc) (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with ;'AEC Retle IU, and upocr completion. /certify, under rhe ains attd penalties of perjury, that the information un t/tis��'catioit Lt•trite and Complete. FIRM NAME: Licensee: LIC. NO.: �r/�c (ii4 Z�y r? Signator LIC. NO.: .-11-9 (Ifapplicable, enter "exempt"in the licen a number line) , Address: �(ieS p-- �- /� tiuy. Tel. No.: _771 C- e f OW NFIR'S iNSUl kANCC�'AIV�R. lam awace that rite eats does not ove lic liability issu ance overage norma y required by law. By my signature below, l hereby waive this r cirement. I am the(check Dere) ❑ owner ❑ owner's agent. Owner/Agent Siunaturc Telep'uonc 4o. PCRMIT FEE: $ 6) //71 Date. . . . . . . . . . . . . TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING 41 SSACMUS� J r'• This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . .:'. �.. �� . �. . �. . . . . . . . . plumbing iNthe buildings ofr... .`/". .:�. �. .!. !. . .. . . . . . .�. . .. . . at .���! (. . . ��!� . . . /l. . I� .L--. ., North Andover, Mass. Fee.� ��.Lic. No.�-6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . r 7 PLUMBING INSPECTOR Check # - 6i .i6 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING �(�3 (Print Type) ,/ t Mass. Dat Permit # Building Ion _/A) I ZL:2 djA Y-, 1,VRype of Occupancy �.5+ D �nl New D Renovation ❑ Replace 13� Plans Submitted: Yes O No O FDCTU S r . x z x b o z = > f= z N < it x N = O z 2 ` d a N F V >i < O. x H W W = Q „� W N G d L? C < 3 s m > H N z C O 7 9 < � fC 3: < W C J _X .G C C !�7. O s d W F. z e o N39 IL 0 Z Z W r,. O u 7C 3 x + a o < � owe m o SUS—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STN FLOOR GTN FLOOR 7TH FLOOR STH FLOOR Installing.Company Name 1'S f�iE2? /.�• ��9mm�47z4 t'� Check one: Certificate Address �nC0A_ N/)'1A&) ❑ Corporation Ir E T14 06-A) 41 Ay IT V/ O Partnership Business Telephone Name of licensed Plumber &A i:- r rr•g eo -INSURANCE COVERAGE: I have a �R ylabYity insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. J. if you have checked yo. please indicate the type coverage by checking the appropriate box A liability kwurance policy ►d Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:i am aware that the licensee hoes 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: Owner O Agent 0 Signature 07 Owner or Owners Agent I hereby certify that d of the details and information I have submitted(or entered)in abase application are true and accurate to the best of my knowledge and that all plumbing work and installations ormed under the permit for this application will be in compliance with all pertmerd provisions of the Massachusetts State Plum ' and er of the t,ws. Title Type of License: Master Joumeymar p License W tuber q3:3 5 TOWN OF NQKH Atj'� JUN - 619 '- PLAN OF LAND /N NO* AND 0 VER', MASS. SCALE.• 1' = 40' ✓UNE 4, 1996 H4YES ENG/NEER/NG, INC. ► 60-T SALEM STREET C/V/L ENGINEERS & WAKEFIELD, MASS. 01880 LAND SURVEYORS TEL. (617) 246-2800 / CERTIFY THAT TH/S FOUNDATION /S LOCATED ON THE GROUNO AS SHOWN, AND THAT /T CONFORMS TO THE ZONING 8Y-LAWS OF THE TOWN OF NORTH ANDOvi-R / FURTHER CERTIFY THAT TH/S PROPERTY DOES NOT LIE W/TN/N A FLOOD HAZARD AREA (ZONE A OR V� AS SHOWN ON FLOOD INSURANCE R4TF MAP COMMUN/TY PANEL NUMBER 250098 0010 B. EFFECTIVE DATE ✓UNE 15, 1983 1t ,�V, of DATE. lI---- ` OME-4 I9x _C SIDNEYC. AGN PROFESSIONAL VD SURVEYOR FIELD, JR. { #15320 Pv S85'-Tl 06,t ss 49.47 1 � - LOT 9 h� 21,835 S.f V TOP OF FND. �4 ELEV.=160.95 a R=175.00 \ L=5.8.3 0 . 77 4000, � L ZONE- P.R.D. (R-2) V.R. F MIN/MUM SETBACKS- FRONT = 20' SIDE = 20' (SEE SEC. 8.5.6.D. 1) REAR = 20' � Location/ �Q 0/J /+ hU. S 7 Date eNQRTh TOWN OF NORTH ANDOVER Of�t�ae y1h p Certificate of Occupancy $ c , # Building/Frame Permit Fee $ l� Foundation Permit Fee $ sA— 16 Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ r� TOTAL $ 4 /Y/ ` Building Inspector 07 1,008.64 PAID Div. Public Works ,Location 5 �U /0 / U No. ? Date NORTH TOWN OF NORTH ANDOVER, - p Certificate of Occupancy $ Building/Frame Permit Fee $ �'��°''^°•''�� Foundation Permit Fee $ �sACMUSE Other Permit Fee $ - r Sewer Connection Fee $ Water Connection Fee $ TOTAL $ ullding Inspector s Div. Public Works Location looe No. PTI Date 9-9G A & j "oRT" o ,TOWN OF NORTH ANDOVER �t«.o ,. h° ° p Certificate of Occupancy $ _ r; Building/Frame Permit Fee $ r. ssncH�sE Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ `t 6- 6�5 Water Connection Fee $ 7` — TOTAL $ r IVnrDiv. ,PEaJiI-4 No. vy APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. V PAGE 1 MAk4-40. '0 ' BLOT NO. 2 RECORD OF OWNERSHIP DATE BOOK 'PAGE • ZONE 0111 -1 ISUB DIV. LOT NO. LOCATION f1 nnl PURPOSE OF BUILDING Sih L (�1'Y11 �� 11 IlR OWNER'S NAME I P 1 1 id Y 1` �� NO. OF STORIES �] SIZ 'd0 �!? I OWNER'S ADDRESS 33 l 0. Jtr MA BASEMENT OR SLAE C O (J (u'l/ n Q•L�-D ARCHITECT'S NAME A'f� A�Vr �I 1`� SIZE OF FLOOR TIMBERS 1ST�1X�O 2ND'jx.iD 3RD'1XQ uflbl'S BUILDER'S NAME 11 u�♦' C L/ 0 f m lt. r, SPAN 1 O' C tl— fly O DISTANCE TO NEAREST BUILDING L,10 1_ D II DIMENSIONS OF SILLSSI- --- DISTANCE FROM STREET 3n I_ I POSTS DISTANCE FROM LOT LINES–SIDES`_ 151 R-as/REAR 66 " GIRDERS` d/` AREA OF LOT /� 91315 13 1, FRONTAGE I a0l HEIGHT OF FOUNDATION l� I�® THICKNESS IS BUILDING NEW pl (4J t,5SIZE OF FOOTING to X n' X IS BUILDING ADDITION D MATERIAL OF CHIMNEY �I LGt ffxY►CL 1 r ltC IS BUILDING ALTERATION O IS BUILDING ON SOLID OR FILLED LAND 601 I WILL BUILDING CONFORM TO REQUIREMENTS OF CODE e L IS BUILDING CONNECTED TO TOWN WATER is BOARD OF APPEALS ACTION. IF ANY [•J IS BUILDING CONNECTED TO TO N SEWER IS BUILDING COjNqCTEljT GAS LI E INSTRUCTIONS P PARTY INFORMATION LAID CO, I q SEE BOTH SIDES ESSUDG. COST MA PAGE 1.FILL OUT SECTIONS 1 - 3 % . BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 \ ` EBT. BLDG. COST PER ROOM Qt SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING � 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATION PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED AV SUILDINO INSPIECTOR S GNATURE OF 6WIWER OR AUTHORIZED AGENT F E E OWNER TEL.# p 76 _ PERMIT GRANTED CONTR.TEL.# �a•�� � 7MK Mid FM 19 d �- CONTR.LIC.# EES MA DUE `RA E PERMIT$40_0-8_'.-6-f H.I.C.# �� &L _ "• * t T7 j k 4• I ,i ,S�•"�.�i 4.. ye -'vV 4 :• - Z� ..y. ....."1, � 111A - 1 �.. ';:}t �V.�i .Y P; Oi- C ti v' ► :tae 4. #L ' } 94 4 C% o � . do _er Mass. _ ` 19 5 COC 'MEWICK11 �' A . . ' ..` '0 E D PQ� t }jigs ' S BOARD OF HEALTH_ g F etc r swc systenir± is UILDING INS- � B PECTOR' THIS CERTIFIES THAT. ...... " / a Found Gaon :;has permission to5eract. . .... buildings on.........�..�.5 :...' ,.. t�.�,�.Lv ! E _ { . =R ugh to be occupied ��S :,: ..... - .. �?,.. ... .�4... �/ Ch mi.e `yam ' .., .. ✓,.rSl .. . . . . ..... ... yt s provided that the person`accepting,this permit shall in every respect conform to :he term afi6 application on�file b" x -Final ,this office, and to the provisions of the Codes and By-Laws relating to thejlnspi ction,.Alteration and,Construction of Buildings In th�� Town I . ow of North Andover. �� �, ;, -, P UMBING INSPECTOR .� I LATION.of the Zoning or Building Regulations Voids this Permit. PERMIT FOR FOUNDATION ONLY ;Rough VIO ' REGULATED BY 14..8 S. B:C ~Firw .l' T-EXPIRES IN 6 MOI\ rHS r .. :` UI )N TRU TIc S, PAIDC7 .GYRI PECTOR. SS S ELl C INS C K R u h .......... ........ �...... ... Service " 4 PE: ..OR k . ed to ' ��- :F &6ziiz Occup Bu`i dings «: R _ 3' GAS INSPEC�OR . w :i� ._ ._ .y ;,r - r"" ,_ ` .•. -:: 3RIlk- Q. gh ©ispla i =Conicuous lack on.the Premises Do Not emove Uathing or*,Dry.Wall To-Be D ane ' fj ` TMENTs� f Until Inspected and,, pprovedYby the Buildin Ins ector IDP �4 g _I p J ` Y.f7u- er '� *- tz- �, J"' w4•.S` 3` it r_. .�,,, "•k S}"'' .s St �.. •.r - e '. #.' eet ke Det.+' E - r FORK U -- LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Appli cant fill's( out this section***************** APPLICANT: A • C, !n C Phone LOCATION: Assessor's Map Number Parcel p� Subdivision WOOD land E6lL5 Lot(s) I Street CD lD n I U I A J� St. Number _ ial Use Only************************ RECO TIO O WN S: 2A114 Date Approvedv Conservation Admiln"i-is-tMator Date Rejected Comments < tY�9Q Date Approved Town Planner y Date Rejected Comments Date Approved Food Inspector-Health Date Rejected -,4A , A,�� Date Approved Sep£ic Inspector-Health Date Rejected Comments Public Works - sewer/water connections �� -�� - driveway permit p7A� Fire Department / U c4_ Received by Building Inspector Date � �-� �� �. .-� . � � � � .: . � 115 Ca�o�,��) ��e✓ r • a�, 835 5, �, r A.c, >�PEN SPACE t,ME-%Z s H c S8XJl'OC F 49.47 1 � I � � X 42.2 lo X 152.1 45' �,NtA 4 Sc' � It S / o It ',19 i r � aT CERTIFICATE OF U5E & OCCUPANCY Town of North And loulldlq POrMit Number _ Date t` THIS CERTIFIES THAT THERUILDfiiG LOCATED ON ht. MAY.BE OCCUPIEDAS IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULAPbNS AS MAY APPLY. *ORTl °;,,.• '�o CERTIFICATE ISSUED TO G� F4 _ s ADDRESS d I i�•wii3Sr. �r •" x Bui ding Inspector NORTH TONM of over Q�,._oc C-Fv„,CK over, Mass., 19 �d agA7 E 0 T c ' 7 BOARD OF HEALTH Food/Kitchen • Septic systemPERMIT T G�LSp� THIS CERTIFIES THAT �� � ��� BUILDING IN SPECTOR Foundation AD T- has permission to erect................ .............. buildings on � { ou to be occupied as............................................... '/.,,�1... ...4..,e........... /.� ....... ...�.......................................... kC . provided that the person accepting this permit shall in every respect conform to the terms'of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of tPLUMBING Buildings in the Town of North Andover. INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT FOR FOUNDATION ONLY 4?—2 a "�'4104 PERMIT EXPIRES IN 6 MONTHS REGULATED BY PARA 114ss. s. ��� tt- � E:� UNLESS CONSTRUCTION STAN' FEE PAID f�v ELECTRI cA�'flJj INSPECTOR i 7 . ................................ BUIL. G INSPECTOR Occupancy PermitRequired p Pito Occupy Building GAS INSPECTOR ' Display in a Cons icuous 'Place on the Premi es — D Rough p s o _Not Remove No Lathing or Dry Walt To 134 Done Final t Until Inspected and Approved by the Building Inspector. FIRE DEPARW. ENT Butner cI 1' . w p` 11-14 A Street No. dt� Office Use Only inti �ummanurettltlt ofitt� ttr u � # Permit No. 3 7J _ igeprtmEIIt of f 11htk _'IIfPtU Occupancy& Fee Checked 3J 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 iph / (XX 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) /fS l a� Owner or Tenant z7cl '09 if Owner's Address �-/ Is this permit in conjunction with as building permit: Yes lL No F71 (Check Appropriate Box) Purpose of Building �1,A1 / . Utility Authorization No. Existing Service Amps _� Volts Overhead ❑ Undgrnd r❑ No. of Meters New Service Amps _J Volts Overhead ❑ Undgrnd No. of .Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work' Total No. of Lighting Outlets No. of Hot Tubs I No. of Transformers KVA Above—; In- No. of Lighting Fixtures Swimming Pool grnd. '—' grnd. Ell KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners i Battery Units No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones Total No. of Detection and No. of Ranges I No. f Air Cond. tons Initiating Devices No.of Heat Total Total No. of Disposals Pumps Tons KW No. of Sounding Devices — T— No. of Self Contained No. of Dishwashers Space/Area H�-,,ting KW Oetection/Sounding Devices - I Municipal Other Dryers No. of i Heating Devices KIN Local ❑ connection i No. of No. of Low Voltade Nu. of Water Heatars K,%A1_. I Signs_ ._ Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP ` OTHER: a . A INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws — I have a cujisent Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YESO have submitted valid proof of same to the Office. YES C----NO — If you have checked YES. please indicate the type of coverage by checking the ato box. ppro INSU,PANCE — 8OND - OTHER � (Please Specify) (Expiration Date) t Estimated Value of EI tric I W rk S Work to Start Inspection Date Requested: Rough Final Q(� Signed under the Penalt es of perlury: /11� LIC. NO. v 7 FIRM NAME ¢' a �-7�f Licensee /a2 i�6�� Signature 1__ LIC. NO. /, / n',' Bus. Tel. No. Address �2 �"����s�1T/ —7�G r Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit applicaeion waives this requirement. Owner [�A9 t (Please check one) (1 Telephone No. PERMIT FES S VVV (Signature of Owner or Agent) x-3505 Date....... a' .. . TO 9 375 '•ORTM °`< ``° ;•�"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACMus� This certifies that . ........ . . . . _......................... T has permission to perform ......... . . .. . .... ..... ....,�.�..�.�.��.�2�t.. .—.:�.........�h wiring in the buil g of/�... ..... /7� ... . ...................................... 8 ........... ,North Andover,Mass. a '!w Fee.... .�.... Lic.N V. l�).............. ....,1„� '_ .. EffcTRICAL INSPEC �tS 0- .4 L/ 3�f 9 WHITE: Applicant CANARY: Building Dept. PINK:Treasurer quo The Commonwealth of Afossachusetts a s� Dcparfmcnt of Public Sofcty Occ�P enc� L (ae O�eckef BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 1200 )/g0 APPLICATION FOR P1ERoMIT TO PERFORMdance�jth the Mac"chutcrua�EdLEC RICAL e. WORK AJU work 6*16c performedC527 CMR 2:00 (PLEASE PRINT Ili IlM OR =E ALL INFORMATION) Date City or Tour of �/�- TA„� ��`� To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & &=ber)_Z_d-T S r _d N/4 L V Owner or Ienant f'?'• C" Gu/1_C/L/L J ��L Owner's Address Is this permit In conjunction with a building permit: Yes a No (Ch ppropriate Box) Purpose of Building /J_0 z Utility Authorization l�77 Existing Service Amps / Volts Overhead ❑ Undgrd❑ No. of deters New Serrice O v Amps Yu Volts Overhead ❑ Undgrd No. of Mete-,s_ _ Number of Feeders and Ampacity. L(� Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Not Iubs No. of Transformers Total No. of Lighting Fixtures Swimmin Pool Above 1CVA ln- b g grnd. ❑grnd. ❑ Generators KVA No. of Receptacle Outlets '•-v No. of Oil Burners No. of Emergency Lighting Batte Units No, of Switch Outlets No. of Cas Burners FIRE AURKS No. of Zones No. of RangesKo. of Air Cond, 1 Iotal L No. of Detection and cons Initiating Devices No. of DisposalsNo. of Heat Iotal Total Pumps ___1225 KW No. of Sounding Devices No. of Dishwashers ' Space/Area Heating KW No, of Self Contained Detection/Sounding Devices No. of Dryers Heating Devices KW Local Municipal Connection❑Other No. of No. of Water Beaters -- KV Mo'nsf Ballasts LowWirVoltage Signg No. Hydro Massage Tubs / No, of Motors Total HP OIT{ER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Lisbilitz Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES[] NO[J I have submitted valid proof of same to this office. YES❑ NO Cl If you have checked YES, please indica to the type of'coverage by checking the appropriate box. INSURANCE ® BOND ❑ OlTfflt (Please Specify) G Estimated Value of Electrical Work S 0 D kExViration ate Work to Start Inspection Date Requested: Rough U/L 69tt_Final Signed under the`penalties of perjury: y =IM NAME -LIC. NO. / License e1(AX".; a,c f A n..�� — Signature — LIC. NO.� Address_- f/7 .4Lf1 /7/ /J'J 11, Bus. lei. No. St/—D 3 b' OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or is su - stsntial equivalent as required by Massachusetts Ceneral vsZa,and that my signature on this peruit application waives this requirement. Owner Agent (Please check one) Signature of Owner or Agent �) �,1 Ielephone No. PERMIT FEE S a6 . �� � Ca ) h Date... . 1.��. ../ '° 325 NORTp °�, ``° :•�"° TOWN OF NORTH ANDOVER 3? .� °'100, c p PERMIT FOR WIRING ,SgACMUSE� This certifies that .... .e...��a.Cl.�ll..u.�.. q. ....... has permission to perform ..... .........t..:f.......� �...... wiring in the building of......... ".- ..:........ ....................... Fee AMass.atGt. . � ... . .... ............................................................. ( UU ELECTRICA LINSPECTOR G C A+07/lWaO3 260.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer ? -�2r I .- '7) 5 2 Date... ..................... ,40RT" TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING S, CHU5, This certifies that ... ................................................................. haspermission to perform ....................................................... ....................... wiring in the building of.................... ...... .t ............ **;-�'. l.-.;r...J- ............................... ,North Andover,Mass. Fed�.. -VIVI . ............... Lic.No % �....... ........... .............. ELECTRICAL MpEcrolz WHITE: Applicant CANARY: Building Dept. PINK:Treasurer -� Co rnonweaA ofY17a»ac tWalEs Official Usc Only Permit No. CJeparinw-1"Ij ira�arvicad BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11199] Heave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perrormed in accordance with the 1'ilassachusetts Clectrical Code(,XIEC).527 CMR 13.00 (PLEASE PRINT IN INK OR TYI'E ALL INFORd•I.MON) llztc: 3�a : /00 City or Town of: Q 0(_1 l-4 �\ 0_h0V E0_ 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) t 4 Lj Co [ on t �L_k aJe_ Owner or Tenant Irl r tS*,o 1•-6 Telephone No. 9 79-6,g 9'.�_805 Owner's Address Is this perinit in conjunction with n building permit? Yes ❑ No [I (Checl:Appropriate Bos) 1'urliosc oC Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of ilIcters . New Service Ams I Volts Overhead p ❑ Undgrd ❑ No.ormeters' Number of Feeders and Ampacity '. Location and Nature or Proposed Electrical Work: �u�-alter .� r(y) ' Cvrn lesion ort$e[•ollvuinQ rcrble Wray be n•aived bs dre brs'ector ol'lYires. No.of Recessed Fixtures No.of Ccil.-Susp.(Paddle)Faus �No.of 'Total Transformers KVA No.of Lighting Outlets No.of Iiot Tubs Generators KVA Above In- t o.o mergency ►g 1t►ng No.of Lighting Fixtures Sisimn►ina Poul ornd. ❑ rnd. ❑ BatteiyUnits No.of Receptacle Outlets No.of Oil Burners FIRE ALAPLIVIS No.of Zoiies t o.o 'Detection and No.of switclies No.of Gas Burners i Initiating Devices No.of Ranges No.of Air Conal. roti No.or Devices Tons o _ No.of Waste Disposers Heat Futup r umber I Tons KW No.of elf- ontained Totals: I Detectio►►/Alertins Devices ► n Municipal No.of Dishwashers Space/Area Heating KZy �C��cviccs oca _ ect►ou ❑ Other No. of Dryers Heating Appliances Kly . or Equivalent Nu.of Water K1V tVo.of No.o Bata iiriug: I•Ieatcrs Si0,►u Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP 1clecommunications Wiring: _ i 1o.or Devices or E uivalent OTHER: Attach additional detail if desired,or as re fuired by the Inspector of{Vires. 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: INSURJ%NCE ❑ BOND ❑ OTHER ❑ (Speci[y) (Expiration Datc) Estimated Value of Electrical Work.. &94• (When required by municipal policy.) Work to Start: r 1 N h►spections to be requested in accordance with MEC Rule 10,and upon completion. f q0 I certify, ander the pains and penalties of perjuq•,that the itrjormation on this application is trite and calnple�te.P•s• ! 11 MUNI NAME: ADT SECURITY SERVICES, INC. LIC.NO.:C1533 Licensee: 13A 5 S E/l Signatur LIC.NO.:C1533 (If applicable, enter."ec.nrpt"in the license number line.) Bus.Tel.No.Q 78-1169 Address: 111 M 0 ORSE STREET, NORWOOD, MA 0 Alt.Tel.No.(781) 278-1131 OWNER'S INSURANCE WMVER: I ant awarc that the Licensee sloes not have the liability insurance coverage normally required by law. 13)•my signature below, I licreby waive this requirement. 1 am the(check onc) ❑ owner ❑ owner's aeent. Owner/Agent —f/ Sibnaturc Telephone No. IPERaIIT F£E: S ��