Loading...
HomeMy WebLinkAboutMiscellaneous - 136 SAW MILL ROAD 4/30/2018 136 SO MALL ROAu 2101104. 000.0 r i • Date..... �.-....:.......... .. t pORTI�, �r;.';�`` ;•_�,,"�o� TOWN OF NORTH ANDOVER 0 . PERMIT FOR WIRING SACMUS� This certifies that ................ ..........1......................................................... SFGu/1�T� Sf has permission to perform ............ ` , wiring in the building of............ ©�... Lic.No.� _C . ,North Andover,Mass. ..�s ..:s....... .............. � < c� Fee ..... ELECTRICAL INSPECTGJ Check # -77 9099 .€ (fotnm.onweahk ol.Mad9acLef Official Use Only c-� a �JeParfinenf o1}ire Services Permit N Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE A LL INFORMA TION) Date: /glad/q City or Town of: /U ' To To the Inspector of Wires: By this application the undersigned gives notice of ht r her intention to perform the electrical work described below. Location (Street& Number) 136 �e.e IPU 1-11 _ Owner or Tenant ; e (o ff.L Telephone No. 7d'03 Owner's Address /.3(p 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: �]:;k)S ySTe'al Completion of the ollowin table ma_v be waived by the Inspec o Noires. No. of Recessed Luminaires No. of Ceil.-Susp.(Paddle)Fars No.of Total Transformers KVA y No. of Luminaire Outlets No.of Hot Tubs - Generators KVA No. of Luminaires Swimming Pool Above ❑ In- o. o mergency rg trng rnd. grnd. Battery 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. TonsTotal No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW No. of Self-Contained Totals: ... Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local Municipal ❑ Connection El Other No. of Dryers Heating'AppliancesK� Security Systems:" No.of Water No. of Devices or Equivalent No. ofNo. of Heaters KW Signs Ballasts Data Wirma: No.of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: 9 7 �&��3 � I Attach odditronal detail if desired, or as required by the Inspector of li%ices. Estimated Value of Electrical Work: ? (When required by municipal policy.) Work to Start: &4 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVER GE: Unless waived by the owner, no permit for the performance of electrical work may issue uniess 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 ❑ BOND ❑ OTHER ❑ (Specifv:) I certifi�,under the pains olid penalties of perjury, that the information on this application is true and complete. FIRM NAME: /4J LIC. NO.: Licensee: ��//,,,, �C'C��ZI(E' 7C/C2 Signatur LIC. NO.:�O214,D (Ifapplicoble, enter "exempt"in the license number linea Address: _ / ' �L.),K2 M �,Lo /��S ,(J 0,30509 Bus. Tel. No.:1o03 r�4��d Alt.Tel. No.: Per M.G.L. C. 147 s. 57-61, security work requires Department of Public Safety`S"License: Lic. No. _135C6o0_0 S/T 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 agent. Owner/Agent Signature Telephone No. _ PERMIT FEE: I . COMMONWEALTH OF MASSACHUSETTS - OF ELECTRICIANS REGISTERED SYSTEM TECHNICII N ISSUES THIS L:CEnSE TO , ARTHUR W PIERCE 1 UPHAM ST SALEM MA 01970-2516 1'024 D 07/31/10 320257' �. --�"off , r,CN'i""OF Certificate of Clearance a J'1 ' Number: SS CC 000517 G Expires:'08/3012010 Tr. no: 152.0 S-License: ADT SECURITY SERVICES ARTHUR W PIERCE HOLLIS, NH 03049 DIG SAFE CALL CENTER: (888) 344-7233 Commissioner . - 1 ._ J 6187 r Date... Ln.. .-.d '� NORTN :•�"° TOWN OF NORTH ANDOVER I- °c p PERMIT FOR WIRING ,SSACMUS� Ab7" SeC u'o' This certifies that .....................�..^............ ./... has permission to perform ! S'� '.l`P' �!a............. ` wiring in the building ... ...../F at .. ... w rL C /....................North Andover,Mass. .... ........ .... .......... '"-� t 53.3L Fee.......�.:'.:"".. Lic.No............ ............... .�. !.......-�.. .....,�,.......... ELECTRICAL INspatrOR i I Check #W 11 0�b I Commonwealth of Massachusetts Official Use Only Permit No. 197 Department of Fire Services Occupancy and Fee Checked j BOARD OF FIRE PREVENTION REGULATIONSRev.9/05 � � ] leave blank i APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TY ALL INFO ATION) Date: -- ©J� j City or Town of: / To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to p--form the electrical work described below. Location(Street&Number) Owner or Tenant 7W,T 51-177 + I .6mAlvgol) Telephone No.?,T— Owner's Address 1 Is this permit in conjunction with a building permit? Yes No X (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: INSTALLATION OF SECURITY SYSTEM Com letion of the.following table inay be waived by the Inspector of Wires. I No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.ot Emergency Lighting gr d. grnd. Battery 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 I} Initiating Devices ! No.of Ranges No.of Air Cond. Total No,of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: "' " Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water Heaters KW No. Signs Ballasts Data Wiring: No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: --� Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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: INSURANCE X BOND ❑ OTHER ❑ (Specify:) SELF INSURED EXPIRES 9/30/06 I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: ADT SECURITY SERVICES .NO.: Licensee: JOHN BASSETT Signature LIC.NO.: 1533C (If applicable,enter "exempt"in the license number line.) Bus.Tel.No. 603-594-5900 j Address: 18 CLINTON DRIVE HOLLIS NH Alt.Tel.No.: *Security System Contractor License required for this work;if Wplicable,enter the license number here: 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 agent. Owner/Agent Signature Telephone No. PERMIT FEE: $#,,15",od Date... .� _0.9... Gf,Nc oT e,hp TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSA USES This certifies that has permission to perform .....S ................................... wiring in the building of........r (.`A;//.P'A!v—o..................................... at..../-A...Sw � ....f�n................. North Andover,Mass. j Oa Fee. -�-�:..... Lic.No. .1.Z.al �.......... .1....... ........... r.LEGTRICAL INSPECTOR Check # 89z� 6 Comrnoa:waal o//i'JassaeliueeUs Official Use Only _� ry� p cc77 Permit No. k �.(�eliarlm:enl o .}ira�erriicad — BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked [Rev. 11/99] (leave blank) APPLICATION FOR PERMIT TO PERFORM. ELECTRICAL WORK All work to be perfornicd in accordaticc with the Massachusetts Electrical Cock(iMEC),527 CbIR 12.00 (PLEASE PRItVT IiV INK OR TYPE ALL i FOR:b1,17'IOrV) Date: -0 City or 'Down of: No /I,U0 U,.e 9 To th!Jn_vj;7e4c roBy this application the undersigned gives notice ol'liis or her intention to perform ctrical work described below. Location (Street &C Number) Owner or Tenant ��� Gr\A —::Y �.-. �t-�V,, ,mara Telephone No. q1�• q'�S, Owner's Address SG,w m, L\ RCC d Is this perinit in conjunction lvith n building permit? Yes ❑ No ❑ (ClrccIc Appropriate Bos) Purliose of Building Utility Aulliorization No. Existing Service Amps / Volts Overlicad ❑ Undbrd ❑ No.of illcters . Ne-.-.,Service Atnps / Volts Overhead ❑ Undgrd ❑ No.ofi Ieters Number of Feeders and Anipacity Location and Nature of Proposed Electrical Work: &,1 /17_, S e /Z' e j e 1 C 1{ too i?:�4 Completion of the folluiving table stay be iraivcd by the leis'cctor of l fires. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of I•iot Tubs Generators KVA Above Ile- i o.o meraencv to itina No.of Lighting Fixtures Sisimniing Pool nand. Eland. El Baste Units b b No.of Receptacle Outlets No.of Oil Burners FIRE ALA.RNIS lNo.of Zones No.of Detection and No.of Switches No.of Gas BurnersTo Initiating Devices No.of Ranges No.of Air Cond. Tons lNo.of Alerting Devices No.of Waste Disposers eat Pump P`funiber 'Tons KW No.of Sell-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ illunicipa ❑ Other Connection No.of Dryers Heating Appliances Security Systems: Ballasts No.of Devices or Equivalent t NO.of Vater KIV ilio.of No.of Data►firing: Heaters Situ BNo.of evices or Equivalent r No.Hydromassage Bathtubs No.of Motors Total IIP 1'elecommunications NVirtng: No.of Devices or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the ourner,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: INSURE\NCE MC 13OND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under the pains and penalties of perjur)',iltat the infortuatiou ou this application is trite and complete: MUNINAI1IE: Buddy Electric Inc LIC.NO.: 12017LA Licensee: Vincent R. Landers JR Signatur. L1C.tia.�23684 E (If applicable.enter "e entpi"in the license number line.) Bus.Tel.No._ t 5-4455_ _ Address: 94 Colgeatp Dr Ti Anti ovimr, Ma 01845 Alt.Tei.No.: OWNER'S INSURANCE WAIVER: I am av are that the Licensee aloes not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(clieck one) ❑o�%mcr ❑ owner's a,,ent. Owner/AgentI��_R, IIT ELL: S Signature 'Telephone No. �� ., :, � , , i i Commonwealth of Massachusetts ED u W City/Town of System Pumping Record Form 4 4 209 kIM SVoy+tee AUG 2. RjH;MID R DEP has provided this form for use by local Boards of Health. I�¢lufioNr�9� T ut the information must be substantially the same as that provided her . B ing this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left side of house, Right side of house, Left front of house, Right front of house, Left rear of house, Ri ht rear of house. Address Cityrrown State Zip Code 2. System Owner: P (2-C Name Address(if different from location) City/Town State Zip Code 915 a7S71 Telephone Num B. Pumping Record q 1. Date of Pumping � F i3^ � I �2. uantity Pumped:DateGallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank E?6her(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: Neil Bateson Name Vehicle License Number F5821 Bateson Enterprises Inc Company 7. Location whe�ontents were disposed: Xnur D Lowell Waste Water Haul r Dae t5form4.doc•06/03 System Pumping Record•Page 1 of 1