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HomeMy WebLinkAboutMiscellaneous - 14 APPLETON STREET 4/30/2018 (3) 14 APPLETON STREET 210/037 0 0000.0 Date..... ...... 11378 O 40RT#j TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that...... ............. .................... . has permission to perform)�..... ............. ............................................ plumbingin the bVildings of............................................................................................. o at.... 44 .... ................................. North ndoVer, Mass. FeeJP-..�. .......Lic. No. ..... ....... ...... ...................%.................................... PLUMBING INSPECTOR Check# A i MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY l Y G J 111ey MA DATEZ -- /J PERMIT# I � JOBSITE ADDRESS OWNER'S NAME P OWNER ADDRESSN4001-6-1i - TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT: PLANS SUBMITTED: YES❑ NO❑ FIXTURES 7 FLOOR— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB j CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM rJ DEDICATED GASIOIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN ` FOOD DISPOSER FLOOR I AREA DRAIN INTERCEPTOR ANTERIOR KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL 'SERVICE/MOP SINK TOILET r URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING -� OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES❑ NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYP COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAI ER:I a that the licensee does not have the insurance coverage required by Chapter 142 of the Massachuse is General L s,a hm aw y signature on this permit application waives this requirement. , 77 K1- ;11*41711 CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE 0 OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and acc e o the st of my knowledge and that all plumbing work and installations performed under the permit issued for This application will be in compliance aN er' t provision of the Massachusetts Stale Plumbing Code and Chapter 142 of the General Laws_ /r PLUMBER'S E LICE #1G (� SIGNATURE MP JP❑ RPORATION PARTNERSHIP❑# LLC❑# COMPANY NAME il jfj,4 ADDRESS 3 CITY STATEv'r�_ ZIP 64 TEL FAX U1 J �!/6' CELL EMAIL .. R J S ' 0 � � � �I � ' J w ..a. p mss.. '^< _ M'F . . . u J ��� �� Division of Professional Licensure: License Search Page 1 of 1 The Official Website of the Office of Consumer Affairs and Business Regulation(OCABR) Division of Professional Licensure Mass.Gov Mass.Gov Home State Agencies A-Z Topics Home>Division of Professional Licensure> ONLINE SERVICES ..............................................-................................................................................................................................................................................................. ...... Check a License Check A Professional License Locate a Licensed Professional By the Division of Professional Licensure Online Address Change Contact the Agency LICENSEE More... Name:WILLIAM M. KANNAN REFERENCES& METHUEN,MA RELATED INFO NEW SEARCH Disclaimer Regarding **This Licensee has additional Licenses,click here to view them.** Website License Searches Glossary of License Status Codes Licensing Board: PLUMBERS ft GASFITTERS License Type: MASTER PLUMBER More... License Number: 10286 Status: CURRENT Expiration Date: 5/1/2016 Issue Date: 6/18/1986 Exam Date: School: This web site displays disciplinary actions dating back to 1993. This license has had disciplinary actions taken during this time. Click here to view this information. The page above has been generated by the Division of Professional Licensure web server on Tuesday,September 29,2015 at 11:20:56 AM. ©2007-2011 Commonwealth of Massachusetts Site Policies Contact Us http://license.reg.state.ma.us/public/pubLicenseQ.asp?board_code=PL&type_class=_M&li... 9/29/2015 r Date....... .. �.`'�............. 3a ,,oATN��$L TOWN OF NORTH ANDOVER al ' PERMIT FOR WIRING` • s ,: • A CHU9�t4 This certifies that ........ ' ....... ' ............ ao� has permission to perform >,� � ,d1I!!,. G.. . wiring in the building of....cl'.f7. .�J,.�.... .f t.�.. i.. .:......................... at ........ .. . N dover,Mass. Fee...............Lic.No. ...... ... ............. ... ....... ELECTRICAL INSPECTOR Check# 12 6 5 7-� I 21-7_11, UY\ 117d I< (fommonweakk o f Mamac4a3etb Officiijal(Use Only c7 i lel 0 cc�� jamp eC J part...of ire Serviced Permit No. Occupancy and Fee Checked r` 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 ALL INFORMATION) Date: City or Town of: 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) Owner or Tenant n 1` Telephone No. Owner's Address Is this permit in conjunction wit a building permit? Yes No ❑ (Check Appropriate Box) i Purpose of Building 1 (, 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: aUyvl & r Completion of thefollowin4 table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- o.o Emergency Lighting No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones of No.of Switches No.of Gas Burners No. IDetection and In itiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Dis osers Heat Pump Number Tons KW No.of Self-Contained Totals:I I I Detection/Alerting Devices No.of Dishwashers S ace/Area Heating KW Local❑ Municipal ❑ Omer r P g Connection a No.of Dryers Heating Appliances KW Security Systems:* t7' No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts 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 lectrical Work: ym (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE RAGE: 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 Vv ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the ains and pe alties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: 9 37�—T Licensee: 9. SignaturLIC.NO.: (If applicable,enter "exempt"in the license number line) Bus.Tel.No.: Address: Alt.Tel No.: -% `� � *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. /1 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 PERMIT FEE: $ Signature Telephone No. MONWEAL H OF MASSACHUSO. . 2 ■ °■ 7¥- 0 ■ . ^ ' f\ -BOARD OF .E Eƒk| q ANl. ' ISSUE ME FOLLOW1 IbEN\{ :\ AS $ ° J RN SMA¥ tECTq' � RICAR% CAR & w ; - � ` § ƒ O!l 7-502- \ k b