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HomeMy WebLinkAboutMiscellaneous - 148 MAIN STREET 4/30/2018 (28) 1 '� 2 4 1 5 Date...... f pOR7p 1 TOWN OF NORTH ANDOVER - PERMIT FOR WIRING SSAcmU Eta This certifies that .......... ............ bas permission to perform ...... ......... ...... ,wiring in the building of..... ....................................... ...... ?.`r,:1....Ser.......�... � ............. ,NorthAndo r,Mass. at..../... � G� Fee...,1�.:......... Lic.No. d ............. .............. . ....... . ....... .... .................. LECrRIEALINSPECTOR.. .. Check # — WHITE:Applicant CANARY: Building Dept, PINK:Treasurer The Commonwealth of Massachusetts °t't a us a%" Dcpertment of Public Safety ••••t` �` of ',� BOARD OF FIRE PREVENTION REGULATIONS.52T Ct.IR 1240 4 fee Gnekee 7/90 (dee:. alai A_ PPLIGATION FQR .PERMIT T3 PERFORM' ELECTRICAL WORK wrk to tie performed In accords""nes w(4h thi Mii iichuscru Electrical Code. 527 CMR 12.00 (PLEASE PRINT IH' I2iIC 08 ZYPE AT.T' INFOR,=,ON) j Date 3aL-pct City or Toon of /1/d. /,�NQd �e�. To the Inspector of Wiress The undersigned applies for a permit to perform the electrical work described below. r Location (Street b Number) A�j ?1AJ �j- a 4,, l 0 Owner or Teaanc ,�pn/w� _46 4e- Owner's Address Lq y y6- Is this permit in conjunction with a building permit: Yes ❑ �y No i.=J (Cheek Appropriate Boz) Purpose of Building Utility Authorization NO. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No, of Meters Z — New spa / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of proposed Electrical Work No. of Lighting Outlets No. of Hot TubsNo. of Transformers � To ❑ l No. of Lighting Fixtures Swimming pool Above In- rnd. gred. ❑ Generators . RVA No. of Receptacle Outlets No..of 011 Burners No. of Emergency Lighting Battery Units No. of Switch outlets No. of Cas Burners FIRE ALARMS No. of Zones No. of RangesNo.�of Air Cond. Tions N�. of Detection and No. of Disposals Neat Total Ioul No. of p s RW No. of Sounding Devices initiating Devices No. of Dishwashecs Space/Area Heating KW No. of SelgSounding Devices Contained No. of Dryers Heating DevDetection/Sounding XW Local❑Municipal Connection❑Other No. Of Water Heaters KWNo, no. o Signs Ballasts Low Voltage Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: IHSURANCR COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Lia Insurance Policy including Completed Operations Coverage or its substantial equivalent. TES i8 II have submitted valid proof of same to this office. YES❑ NO ❑ f you have checked YES, please indicate the type of coverage by checking the appropriate. box. INSURANCE C3 BOND ❑ Mn❑ (pleaaa Specify) Estimated Value of Electrical Work $ -6 p (piration at Work to Start Inspection Date Re uestedt , q Rough Final_ Signed a.�er he penalties of perjur;: FIRM NAME �Licensee LIC. NOSignature Address — NO- 6a�'Ta— Bus. Tel. No. - RANCZ —Alt :tsntOWNER'S INSuivale 17AI : I as aware that the Licensee does not have the•insurance coverage or to su stantial equivalent as required en Massachusetts Ceneral vs�Est my signature on this permit application valves this requirement. Owner Agent (Please check one) / Signature of Owner or Agent Telephone No. PERMIT FEE S v v > Date. No f. 6 J TOWN OF NORTH ANDOVER 0 p PERMIT FOR PLUMBING ;,SSAC HUSfc� This certifies that . . . . . . .•. . ... . . . . . . . . . . . . . .'f. . . . . . . . . . . . . . . . . has permission to perform . +.-. -- : . . . . . . . . . . . . plumbing in the buildings of'.17114 "�? !-. . . . . . . . . . . . . . . . . . . . at . .�`?�A. . . '`'-' . . . . . . . . . A. , North Andover, Mass. Fee`` . . . . . .Lic. No.. �^. f . . . . / PLUMBING IN5 E✓.OR Check # G� 97 WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) i✓�0VL.e i_ A16. Mass. Date 47-94,10 Permit# A/4 �� s• . ` '/ p Building Location �'Y1 /)')A/N L>% y/,�D Owner's Name,;µ �o�i�:t?�.r"��#Ve'� an Type of Occupancy Ne ' ❑ _ P cY w Renovation ❑ Replacement ©� Plans Submitted Y No Ct FEATURES z z z cn o z UWn Z Q a- Q U F- z C7 ¢ Q O w F- W °� U CE U) Q O Z z z a J (n m 2 � Q W Un Y Q W Q IL :;z 3: X Q) ZQ W W Q U) tr 2 Q w Z 0 Q U) Z Cr a It O u_ H - Q 2 _ 0 U= Y a. Q Q Y W LL X W Q F- Q X U_A U_) QQ Q 0 z 0 0 Q 0 ¢ ¢ Q U = Y m U!! O D J = F- W LL C7 0 o Q � ¢ m O SUB-BSMT. BASEMENT 1ST FLOOR. . 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name!�Qw,()/( (57(9rJVCT,-,i9 pzzwlQ c )107 Check one: Certificate Address �7 S /`�/(J S7-1 U r �� 11�/ / Corporation /T G`�7 sS�/ Q Q Iff C9 16 ,17 ❑ Partnership Business Telephone / U ' � '— 6 ia-frm/Co. Name of Licensed Plumber 1'�A "Y +; (57-eCl/l�c�17- i INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142. Yes 2-' No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy 3 � Other type of indemnity f 7 Bond ❑ OWNERS 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: Si nature of Owner or Owner's Agent Owner ❑ Agent ❑ 1 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 permit Issued for this application will be in compliance with all pertinent provisions of the Massachusett lata Plumbing Code and Chapter 142 of the General Laws. By igna urs o icensa um er Title Type of License: Mast �� Journeyman ❑ City/Town License Number /O APPROVED OFFICE USE ONLY)