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Home My WebLink AboutMiscellaneous - 1160 GREAT POND ROAD 4/30/2018 (25) f a �� ( . Date . .7-4 7- �Z. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . . . . . . CSS has permission to perform .SF-1.e1/nc '00 wiring in the building ofr.� at .l.I�0 6:�2P 0��0 A?.6, . . . . . . , . . . ,/North Andover, Mass. ee . 2S a--L c. No. P.1 S3J-S. . . . . . . . . .l ELECTRICAL INSPECTOR / eck# S�Sn 10962 Cbm►'nonwe l#h o`f l�I 6011,11 0# affr��al t onlay I'ennitNO �OARC� OF FIRE PRVEi� `ION f • GULATIDN:S Qccupancy and Fee Checked [12ev 11/99) leave blank' >APpL��A .FTIOW Fit I =RIII�S't tdiOt r` L � 'I1Al� WK AT]work.to:be.perfiormed-in:accordance) il. he Massaehusetts:;'Electncal Code(lv1EC),527 CMR.'l2 00 PLEASE-PRIIVT:IN INK OR TYPE ALL IVFdR1bIAT10N date. Clty or,Town of IN ova r To the In of Wires: By this application the undersigned gives;hotice o'fhis or;:her intention.o:perf rm the electrical work describedbelow. S Location(Steeet&Number) 1( �jU �rch�.�d td 5 St,. S eve M i ��/ t. Omer or Tenants Ccu1C S c a Telephone No R owner's Address;: _tt6.0 G 1s this prter nm conluuction with a building permit? Yes:. (Check AppropHale,06 k) irpose of 4k49 v lityAll 0 1za'tlon Exist-ng Service.tc7 V-:. Amps tict .% I'ItQ ;Volts bverh6ik lUndgrd 0 ;No1 of lVleters, :^ � . Nein Servicetl 't,'olts Overhead Undgrd.,0 No.of Meters Number of Feeder"s and Ampacity Location dM of Proposed Electrical Work V t Sir o,cccx..41 ee,r av t S completion Of the-ollowin table,ma ..be.waived by theins tWta o Wires. N o'o 0 of Recessed fixtures No ofetl-Sus addle Fans otn. P �' ), Transformers VVA No of Lighting outlet's No of HotTubs Generators KVA ove:: n- o o mer. ency`,ig mg Na ofsLi ht�h Fixtures Sw�mmiii I'ooC [] g : g....:.. _ . . . .. rnd !Wke .Un.its No of Iiece tacle Outlets 3 No of Oil tuners FIYtE.4I AR1S No of Zones P_.... : Noy of Switches No of Gas &hers o o etection an Imtyarm Deuces ota.. No of Rit rages " No,of Air Corrd No .of Alerting De�;iCes di Tons:.... _.. .. .. No of Waste his osers:` eat utti uni er ons o o e ontalne p p Defection/. ettin :Devices.: ,. Totuls No 6f I)�shwashe"rs S aCe/Area Heatin Kms! Local [�] unlclpa ( Other . p g . C:onn'ctiotS No o£D ers FleatingApphances KW tY ec Sr No ofI�lzVes:orE �tiv.alent o,0 5 =stet , o 0 0 o Data Warm." beaters Ballasts No of bgeVa es;o"r E urvalent .. Si No Hydroniassage Bathtubs No of Motors 'Total HP e'ejtloo T�v> es br lu valent.::. O Attach additional detailifdesired,,or as required.by the lnspeetor.of Wires: INSURANCE COVERAGE: Unless waived by;the.owner,no°.permit for'the,perforinance of electrical wdrk may..assue unless, th'e license' prdvides proaf of haliility insurance including:"completed operation"coverage or its substantial 44tuvalent; The,. ,. undersigned certifies that Such coverage is m force;and has exhibited proof of same to the:permit issuing office CI3);CK ONE INSURANCE 01Nb `011 R [] .(Specify:) (Expuatidn Date) t✓stimated Value of Electrical Work IY GG_u c (When xequir..pd by.:municipal..pohcy.) Work to Stiait -Inspections to;be requested in`accordance with,Ivl)✓(✓Rule l0,and upon completion. Y certtfy,under the pains lino pen.tflties of penury;that the inriiatt n this applacafi ue ttt3d cvHtplete ItTR NA u>^ci r e C�� t C �` C LIC -N0 Licensee . n.� c,n�i �rycm�c Signator LIC. exem lice NO 31,5 (Ifap�ihca67e enter'' t."to the nse.numb lin .) Tel No Q 112=S$'►"► Address :`fa5 'A.c o ,dLZ �. 'F.. Ea�r� . : G AIt Tel No Say 3`I$ �q�j:1 OWNR':5 INSURANCE WAIY= R I;am aware that tike Licensee dries not ave the liability in. normally wner's required by law ,By my srgnatttrebelow,I herebywaive tihis requiremen4:;:I am the(check one owner, Owner/Agent PFRNlIT FEE; $ Sigfiatu►�e: Telephone No. Date. . . . .. ... . NORTH �2 TOWN OF NORTH ANDOVER FO A • - PERMIT FOR GAS INSTALLATION c.•' 4h SS^CMUSEt l This certifies that . . . . . . . . `.'. . ' . has permission for gas installations .. . . . . . . . . . . . . . . in the buildings of . . . . .. .'.'. . . .... .:K /. .;'.� � ?..�. . . . . . . . . . . . . at �� !.!. . . . . . . . :'. . . �. . . . . . . . . . `. North Andover, Mass. Fee..'" . . . . . Lic. No..!. . ��5 �.�_._ � X... . . . . . . . /l GAS INSPEC Of(, Check# 3 7 f. MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING (Type or print) Date �` d NORTH ANDOVER,MASSACHUSETTS \ Building Locations6 oS Permit# ount Owner's Name k New❑ Renovation ❑ Replacement ❑ Plans Submitted ❑ a ° ° a z H � p � w W r� 0 SUB-BASEM ENT BASEMENT 1ST. FLOOR / 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR (Print or type) 4L one: Certificate Installing Company Name U �. Address r O ❑ Partner. Business Telephone ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter U INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked yes,please indicate the type coverage by checking the appropriate 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 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: ❑ Signaturr 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 a tion are true and accurate to the best of my knowledge and that all plumbing work and installation o de ssu f .s application will be in compliance with all pertinent provisions of the Massachusetts S to d 14 a neral Laws. By: Signature of Licensed Plumber rFitter Title ❑ Plumber City/Town ZGF' r =eum er ter APPROVED(OFFICE USE ONLY) ❑ Journeyman N° Jil, 7 Date.............. ............ f NORTH, 3r°. "oo� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,sSAC14USEt This certifies that ......��!' .�/.T�..... <.. r� �.r� .... ...................................... has permission to perform ...1! P. .....S pI c �- .................................................. wiring in the building of................................................................................... at............................................................................... .North Andover,Mass. r— cJ Fee.......35..... Lic.No. l 8637.............. /{l�.l. ............... �7 ELECTRICALINSPECTOR Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Official Use Only Permit No. 26—Y 7 9 "''✓�"�' S` Occupancy&Fee Checked 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 To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number I [7 C? ,"t�eu �'® y SCJ — ll& G Owner or Tenant ✓✓C ,es Owner's Address Is this permit in conjunction with a building permit Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Author¢ation No. Zv Zyo Existing Service IG7L) Amps � Vohs Overhead Undgmd ❑ No.of Meters j New Service /lid Amps Z Voits Overhead j Undgmd ❑ No.of Meters Number of Feeders and Ampacity �G�� Location and Nature of Proposed Electrical Work Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures Swimming Pool grnd ❑ grnd ❑ Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Di osal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers Space/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other No.of D rs Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO = have submitted valid proof of same to the Office YES= NO = If you have checked YES please indicate the type of coverage by checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) /,:AO U (Expiration Date) Estimated Value of Electrical Work$ Work to Start Inspection Date Resquested �-1d-�Z— _ Rough Final Signed under the Penalties of perju FIRM NAME +G-�/'� / LIC.NO. Lkensee 101),- Signature LIC.NO. Bus.Tel No. Yl 61-2- -6 Z 6 2— Address - Alt Tel.No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent)