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Home My WebLink AboutMiscellaneous - 1475 TURNPIKE STREET 4/30/2018 (2)N O O v 0 �i b d Date .. F. s! n z Cq—6G.... t TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSACMUSE� =+....................................... This certifies that............ has permission to perform ..........J� .G........;PM'4.! x ........................ wiring in the building of ..... 4K*eIS, ..................:......................... at ...... ..q - �! c!/O!r r .... S r' .................. . North Andover, Mass. Fee 6- ...'"......... Lic. Noy/..�Yf�..................../.: . ELECTRICAL INSPECTOR � Check # o`' `7_% 7060 Commonwealth of Massachusetts Official Use only M Department of Fire Services Permit No. 7� Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] (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: \\— 2 0 — (p City or Town of: NORTH ANDOVER 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 & Owner or Tenant Owner's Address Is this permit in conjunction with a building permit? Ves Q Purpose of Building , ,,.Wy.._ kyy-.& Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: No ❑ (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Completion ofthe following table may be waived by the Inspector of Wires. 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- El rnd. rnd. o. o mergency ig mg Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. o Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pum Totals Number Tons KW o. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municippi ❑ Other Connection No. of Dryers Heating Appliances KW -of Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. o —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: Se.VW 1'r a —.9% Attach additional detail if desired, or as required by the Inspector of Wires. W Estimated Value of Electrical Work: Se (When required by municipal policy.) Work to Start: \\_ Zit OLD 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 ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains andpenatties of perjury, that the information on this application is true and complete. FIRM NAME: kee � L LIC. NO.: Licensee: ��eti ae,�.VCts le v�r�ev-� Signatur LIC. NO.: g345'R (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.Jlob36AC0I Rl 1 Address: ,cN-V�k• • b\01 Alt. Tel. No.: *Security System Contractor License required for this work; if applicable, 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: $ Date. /� : �. ��....... . TOWN OF NORTH ANDOVER ;-� PERMIT FOR GAS INSTALLATION w. This certifies that, :�:.'" .' ."................... . has permission for gas installatio_n,<�-.'-.-:�--............... . in the buildings of ....... '` `........ ^................... . A at .... , North Andover, Mass. Feed....... Lic. No ............. . GAS INSE4,1 �OR Check # Li 3650 i.9 MASSACHUSETTS UNIFORM APPUCATION FOR PERMIT TO DO GASF1TTING (Print or Type)07 ' - o�4146 OW , Mass. Date_C�,� 9- o'�)d I Building Location P/2L6 JOY0Owner's Nam2L.&A646ra: e Type of- coup Permit # 1 ---)CN T r -j New ❑ Renovation ❑ Replacement Lv!:�� Plans Submitted: Yes❑ No m (i 14!5, ing Company Namee, Ae 1Z T A : to Ma Tri � 0 Check one: Certificate Address !� U Cn4 C H ih a ry LfI . ❑ Corporation 1%_ 111 E 7 H UE fJ 01 rl U 1 y ❑ Partnership Business Telephone /a -9Z -5 9 "7 f 2-Firm/Co. Name of Licensed Plumber or Gas Fitter "'La- ?- T A • al P(--) INSURANCE COVERAGE: I have a curre_nt pj bility insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Gd' No ❑ If you have checked Yes, please Indicate the type coverage by checking the appropriate box A liability insurance policy Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 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 Owner❑ Agent C3 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 the pe i i ed for this application be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of ner Laws. By T of License: C� Plumber t-WhAture of Licensed PlumAWor Gas Fitter Title tter License Number WJer rneyman za iONEEMEEIREMEMEMEEM MEN MEN ing Company Namee, Ae 1Z T A : to Ma Tri � 0 Check one: Certificate Address !� U Cn4 C H ih a ry LfI . ❑ Corporation 1%_ 111 E 7 H UE fJ 01 rl U 1 y ❑ Partnership Business Telephone /a -9Z -5 9 "7 f 2-Firm/Co. Name of Licensed Plumber or Gas Fitter "'La- ?- T A • al P(--) INSURANCE COVERAGE: I have a curre_nt pj bility insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Gd' No ❑ If you have checked Yes, please Indicate the type coverage by checking the appropriate box A liability insurance policy Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 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 Owner❑ Agent C3 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 the pe i i ed for this application be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of ner Laws. By T of License: C� Plumber t-WhAture of Licensed PlumAWor Gas Fitter Title tter License Number WJer rneyman za