HomeMy WebLinkAboutMiscellaneous - 122 CHADWICK STREET 4/30/2018 (2) r 122 CHADWICK STREET U-2 \
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DEPARINWOMBUCSAFM Permit No.
BOARDOFFMTWrrH
NREGULAT70NSSl7C1 IZIM
Occupancy&Fees Checked
APPLICA77ONFOR PPERFORM ELECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANASSACHUSSTSELECTRICAL CODE,S27 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFO. Date 0
Town of North Andover
To the Inspector of Wires:
The undersigned applies for a permit to` rform th electrical work described below.
Location(Street&Number) 4 3 �Q Q °
Owner or Tenant 19+•+.1 ar•e f f iu v t'C
Owner's Address Z l
Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box)
/J
Purpose of Building a 0.Q</.i�* Utility AuthorizatioNo.
Existing Service 100 Amps �Volts Overhead M Undergiou�td a No.`of Nlgters /
New Service Amps Volts Overhead ED Underground No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work J e 4 aU
No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
TVA
No.of Lighting Fixtures 2 Swimming Pool Above 0 Below Generators KVA
ground groand
o.of Receptacle Outlets �3 No.of Oil Burners No.of Emergency Lighting Battery Units
o.of Switch Outlets
No.of Gas Burners
o.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones�o
s� Tons
rorot Disposals No.of Heat Total Total No.of Detection and
Pumps . Tons KW Initiating Devices
o.of Dishwashers Space Area Heating KW No.of Sounding Devices
No.of Self Contained
Detection/Sounding Devices _
o.of Dryers Heating Devices KW Local a Municipal Other
Connections
o.of Water Heaters KW No.of No.of
Signs Bailasis
o.Hydro Massage Tubs No.of Motors Total HP
ER•
Ftasuarilodretet}marlaisofNlassad7t>s�sGartaalLaWs ao
aamat1i*kksuiatneFt&yirduftCanple� critssub9atriale#vala�t YES NO
srt i*dvafidptoofofsaneoDdr0iica YES lfyouha%edrd1wdYESp�eindraledielypeofaneiVby
the boot
Esmr*dVatleofDtxtiical Wok$
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rade ParaldesofpejuT..
NAME LiomNa
Lioatsee sigroaae LioatseNo
Bas�ressTeLNdL
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rL,i,�S 'SINSURANCEWAIVER;Iamawar dridleLio=doesnothmedleiriaaa=aNa*oritssubsrarialgxwlentasm4medby Cten WLaw+s
andel atrrrysigrlAmonthis'PWJ1Lq4X&3U1W4XMftregtirerrlait
(Please ch Own Agent
Telephone No. PERMIT FEE$
signature or Owner gen
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Date
NORTN TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
SSA�NUS�
This certifies that . . . . . . .` . . . . 5` . .. .. .`. . . , ", , , , , , , , , , , , , , , ,
has permission to perform . . . . �c, f, . . . . , , , , ,
plumbing in the buildings of C. . . . . . . . . . . . . . . . . . .
at. . .�.f .1. . . . ./. /a <- ! t. 1. . . . . , . . , North Andover, Mass.
Fee. Lic. No.. . . . . . . . . .� ,--N. . . . .
PLUMBING INSPECTC7
t
Check #
615
MASSACHUSETTS UNIFO APPLICATION FOR PERMIT TO DO PLUMBIN
(Type or print)
NORTH ANDOVER,MASSACHUSETTS r l
�� k . �tv t`C Date
Building Location v�ners Name Permit#
Amount
Nie of Occupancy
V,
New Renovation Replacement E] Plans Submitted Yes No ❑
FIXTURES
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VN
LC-1 WE i1
+SE
`• 2�1�
r M HEM
H-OCIR
5M Iffm
6M FLOCIR
MQ 1�
8IH 1�
(Print or type) n C / Check one: Certificate
Installing Company Name r( ) ��2�1C N �� 14 ElCorp.
Address .�—b d X 1—V IL El Partner.
Business Telephone 13—Firm/Co.
Name of Licensed Plumber: 13'D h
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnityEl 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 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 Iss ed for this application will be in
compliance with all pertinent provisions of the Massac is State mbing qode and C er 142 the General Laws.
By: igna ure 31 Licenseaum
Type of Plumbing License
Title -�
City/Town ice e um er Master [3— Journeyman ❑
APPROVED(OFFICE USE ONLY