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Home My WebLink AboutMiscellaneous - 122 FOREST STREET 4/30/2018 122 FOREST STREET / 210/106.A-0008-0000.0 i I A Date.......t..'Jf...... y NORTH °f'"'°;•'"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHUS This certifies that .�d 2.......... 1.... . .............................G' has permission to perform ... .. ................................. wiring in the building of..... ....................................... n at... /.............�.1-1; ........ Orth Andover,Mass. Fee...:: ..... ' Lic.No..9 d. Z ............. �. .. ... .... . y ..... ELECTRICAL INSPECTOR Check # �— r X0635 ir } 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§3L,the •% permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed "U) on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an +� electrical permit shall be issued to the person,firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time of.ongoing construction activity,and maybe-deemed-bythe.Inspector_of_Wires abandoned_and.invalid-ifhe.—_. ._ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending1hrough August 15,2012. ERulleiS—PermitfDate Closed: —l� --�4�• *'� Note:Reapply for new permitxtension Act—Permit/Date Closed: -44 C orrtrrwruvealth o� a3eac�u�et`f� Official Use Only c� Permit No. �.CJe artment o ire�eruicee - p Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank APPLICATION®N FOR PERMIT TO PERFORM ELECTRICAL WORK All work to bePerformed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINTININK ORTYPE ALL INFORAMTION) Date: z Ci or Town of: C v To the Ing ect r of Wires: City o �r By this application the undersigned gives notice'of his or her intention to perform the electrical work described below. Location (Street&Number) lr Z Sf SI Owner or Tenant 1 C1 �kh 5 e ak4 ex—j 6 v Telephone No. Owner's Address avvt C Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical (Work: RF u vS ca,e P76-1 - ✓cwt � �'>SG. -�ty Y2StG'IKC Completion of the followingtable may be waived by the Inspector of Wires. �v No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total i Transformers. KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In No.ofEmergency tighting No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices Disposers Heat Pump Number Tons 1CW No.of Self-Contained No.of Waste Dis P Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating I(W Local❑ Municipal ConnectionEl Other No.of Dryers Heating Appliances Security Systems:* Int No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent dromassa e Bathtubs No.of Motors Total HP Telecommunications Wiring: No.H y g No.of Devices or Equivalent y OTHER: Attach additional detail if desired,or as required by the Inspector of YYires. Estimated Value of Electrical Work: RoO• CU (When required by municipal policy.) Work to Start: 0 2 Inspections to be requested in accordance with NEC Rule 10,and upon completion. INSURANCE O GE: 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: INSURANCE [�J BOND ❑ OTHER ❑ .(Specify:) I cert,under the pains and penalties ofpleriury,that the information on this application is true and complete. FIRM NAME: &Ld i-e it2a tas ' t l C LC LTC.NO.: 17(JaZ_ Licensee: 65;,n Iq O lar V a h-to Signature LIC.NO.: (If applicable, e ter empt"in the license number ' e.) Bus.Tel.No.:97�' 1F27"0 6 0 Y Address: o a✓1 d va v-( �� Alt.Tel.No.:— 346�� yo *Per M.G.L.c. 147,s.57-61,security work requires Dep ent of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's amt. Owner/Agent PERMIT FEE: $ Signature Telephone No. I OF NORTH o� TOWN OF NORTH ANDOVER 41 PERMIT FOR GAS INSTALLATION h SACHU5E��( t l O This certifies that . . . /.�. .<. .� . . . '. . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . 11).'. in the buildings of t . . . . . . . . . . . . . . . . . . . . . . . at . . .f.7.1. . . / .. . . ..'. . . . . . . . . . . . . . . . .. No`rth_Andover, Mass. Fee. :.U.�-. Lic. No.. ,/<:.� � . . . . . . � . . . . . . �ASINSPECTOR � Check# 42U8 U �^ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or T ) Zlw—e, . Mass. Date l/// Z 20 Z Permit # Z Building Location r/a h Ine J/• Owner's Name vllulf �¢ � Type of Occu //.. panty /o w New ❑ Renovation Replacement ❑ Plans Submitted: Yes❑ No� N GY W N N fA (� Z ¢ N y ¢ N ¢ p ¢ y f- ¢ Z F W J N W O V rp t Z til < ¢ O O F ¢ W < J W Ips- N d ¢ < M ¢ W = V WW cc 12 W < ¢ H c h = 0 H Z J F- Z F. W W O O '! fa +' t? J W 3-0W Z < W < a) m 2 0 Z U, O Z < W ¢ Z, < ¢ < ¢ '= O t1 Z 4. 3 G O J V ¢ Y SUB-8SMT. BASEMENT 1 ST FLOOR 2ND FLOOR ' 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR TTH FLOOR 8TH FLOOR Installing Company Name Check one: Certificaten Address )✓ Ur Corporation T L ❑ Partnership Business Telephone f ❑ Firm/Co. Name of Licensed Plumber or Gas Fitters/� INSURANCE COVERAGE: I have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No 0 If you have checked ye . please Indicate the type coverage by checking the appropriate box A liability insurance policy Other type of indemnity O Bond O 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: Signature of Owner or Owner's Agent OwnerO Agent O I hereby certify that all of the details and information I have submitted(or entered)in above application are true and rate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this; pp� in pliance with all Pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene T of License: t' c Plumber Sig a of icer as umber or GFitter Title Gasfitter Master License Number CihdTown Journeyman O I ONL BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO DO OASFITTING NAME,A TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE_20 OAS INSPECTOR Date.le. N° t_ 64. 0, s TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACHUS (` i L This certifies that . . . . . . . . . . . . . .r. . . . . . . . . . . . . . . . . . . . . . . . . . r� has permission to perform . . . .11�'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . l . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. � 1 Fee.1. �. . .Lic. No. �. '. . . . . . . . . . . . . . . .!^:flz:^� . . . . . . PLUMBING INSPECTOR Check 'I WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT -O DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date I Building Location ``^ �6 GOwners Name -61471 � 6 y Permit# � Amount Type of Occupancy New Renovation Replacement MPlans Submitted Yes ElNo FIXTURES a W Hdz CrCr Cn AlH a W x W a w aEn w Q a a x E-+ d Q fS. W v F A A a ad d "t Q d m SERB &�41�II�ir IST:FiOQt �IImt 3M F OQ2 4IH FUM SIH HIM 6IH FLOOR 7IH FLOOR 91H HDQt (Print or type) ` J / q _ 1 Check one: _ Certificate Installing Company Name f-. ( �C— > � aeO i Corp. Address Y"`��'J a �--� Partner. 4-b �-,�f`h a Business Telephone (4 j8--6 a14 9 q G Firm/Co. Name of.Licensed Plumber 5 -/(A V'F) Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ 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 Issued for this application will be in compliance with all pertinent provisions of the Massachusetts ate Plumbing 2 of the General Laws. By: igrra ot Licensedum er Type of Plumbing License Title (,.E 5 City/Town icense i um er Master Journeyman ❑ APPROVED(OFFICE USE ONLY