HomeMy WebLinkAboutMiscellaneous - 15 WILEY COURT 4/30/2018Date ... ?//I // � ........
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that ....
................
has permission for gas installation ... .........
in the buildings of . . .......................
at . . . J7.M lel.. � .............. North. -Andover, Mass.
Fee.,4i;;�<4 Lic. No... . ....,/
GASi�i��PEC
Check # I_IM40
8323
=' MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
CITY IA4 M� �%1A�UU2iY MA DATE 9/G aZ PERMIT#
JOBSITEADDRESS -/6 CT OWNER'S NAME
G _
OWNER ADDRESS '/J I�Je% �' / TEL 97� %.../ &S FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL,EDUCATIONAL : RESIDENTIAL;
PRINT
CLEARLY NEW: RENOVATION.:__' REPLACEMENT: PLANS SUBMITTED: YES NO '^
APPLIANCES 7 FLOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BOILER _
BOOSTER 4
........ _. _.
CONVERSION BURNER
COOK STOVE
DIRECT VENT HEATER
..
DRYER _...... .. -
FIREPLACE
FRYOLATOR
FURNACE
GENERATOR 993910(3 6`"T..
GRILLE
h
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT
OVEN
POOL HEATER
ROOM I SPACE HEATER-��
ROOF TOP UNIT
TEST _
UNIT HEATER
UNVENTED ROOM HEATER
WATER HEATER
.OTHER ` ..
..:�_
INSURANCE COVERAGE
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch.142 YES L NO
IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY BOND
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
CHECK ONE ONLY: OWNER' AGENT
SIGNATURE OF OWNER OR AGENT
I hereby certify that all of the details and information I have submitted or entered regarding this 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 complia a with all Pertinent provision of
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER-GASFITTER NAME : David Youngblood LICENSE # 9264 A' URE
MP ; i MGF�� JP JGF1 LPGI CORPORATIONS # PARTNERSHIP _ # LLC 'w #
COMPANY NAME: Youngblood Co., Inc. ADDRESS 32 Ashland Street
..._ ....... ... _ _ ...__ _ . _.._ . _....... ......
CITY ' Haverhill STATE MA :ZIP 01830 TEL 978-373-5607
FAX 978-521-1572 CELL EMAIL dyoungblood@youngbloodco.com
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GENERATOR APPLICATION
DATE:
LOCATION:
OWNERS NAME:
GENERATOR kw 20
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NO INSTALLATION OR GROUND DISTURWANCE BEFORE APPROVALS*
CONTRACTOR: zvo.,eL &' . —z-' It' -
PHONE NUMBER: 77�, 07R, t35
ELECTRICAL
`RESIDENTI
GAS
COMMERCIAL TEMPORARY
LOCATION OF GENERATOR:
*ZONING DISTRICT:�—
�'0
*CONSERVATION APPROVAL ��-
This certifies that ......,aUj
has permission to perform ...O./� ,?Z..... .
wiring in the building of ..... S�,!//.Li�f/,Ea,� S. c� ........
at ... �, 1. L -z--- -- � - ..-�C.? 7 , . , , , , , , , .. North Andover, Mass.
Fee . Lic. No..
�+ ELECTRICAL INSPEC OT Rx�
Check # C DO
11083
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Commonwealth of Massachusetts Official Use Only
MEMO
Department of Fire Services Permit No.
0
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. 11/991 (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: 9-6-12
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 & Number) 15 Wiley Ct.
Owner or Tenant: Richard Shaughnessy Telephone No. 978-687-1963
Owner's Address: Richard Shaughnessy
Is this permit in conjunction with a building permit? Yes No x (Check Appropriate Box)
Purpose of Building: Dwelling Utility Authorization No.
Existing Service Amps Volts Overhead ❑ Undgrd ❑
New Service Amps Volts Overhead ❑ Undgrd ❑
Number of Feeders and Ampacity
No. of Meters
No. of Meters
Location and Nature of Proposed Electrical Work: Installation of emergency stand-by generator and transfer switch
Completion of the. following table may be waived by the Inspector of Wires.
No. of Recessed Fixtures
No. of Ceil: Susp. (Paddle) Fans
No. of Total
Transformers KVA
No. of Lighting Outlets
No. of Hot Tubs
Generators " 1 KVA 20
No. of Lighting Fixtures
Swimming Pool Above ❑ In- ❑
o. of Emergency Lighting
rnd. grnd.
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS I No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Initiating Devices
No. of Ranges
No. of Air Cond. Total
Tons
No. of Alerting Devices
No. of Waste Disposers
Heat Pump
Number
........................
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 KW
No. of No. of
Data Wiring:
Heaters
Signs Ballasts
No. of Devices or Equivalent
No. Hydro massage Bathtubs
No. of Motors Total HP
Telecommunications Wiring:
No. of Devices or Equivalent
OTHER: Siding
Attach additional detail if desired, or as required by the Inspector of Wires.
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)
On File
Estimated Value of Electrical Work: $7,500.00 When required by municipal policy.)
(Expiration Date)
Work to Start: Week of 9/17 Inspections to be requested in accordance with MEC Rule 10, and upon completion.
I certify, under t e pains an peva tes of perjury, that the information on this application is true and complete.
FIRM NAME: Youngblood Co., Inc. LIC. NO.: 960M
Licensee: Chad Amodio Signature LIC. NO.: 960M
(If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 978-372-5885
Address: 32 Ashland St., Haverhill, MA 01830 Alt. Tel. No.: 603-608-7558
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: $55.00
CAA rl- IV6A�kr cil�- to\2tz
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GENERATOR APPLICATION
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DATE: /o/
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LOCATION: 15- ov
OWNERS NAME:
GENERATOR kw 2 /< 4" {' fZ 64
NO INSTALLATION OR GROUND DISTURBANCE BEFORE APPROVALS*
CONTRACTOR: t 01d "d- &
PHONE NUMBER: 77e 072, f35 -
ELECTRICAL
t
IDENTI
GAS
COMMERCIAL TEMPORARY
LOCATION OF GENERATOR:
*ZONING DISTRICT:_ 7�
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*CONSERVATION APPROVAL 5 I;t- C�-ph
TOWN
PER
,SSACHUS
Date.
RTH ANDOVER
FOR PLUMBING
This certifies that ... ......................
has permission to perform .... ..........................
plumbing in the buildings of ... 5.� P. ..............
at ... f . -7... c-- ........... North Andover, Mass.
Fee..3 Lie. No.. ?.3.'.. ......... ......
PLUMBING INSPECTOR
Check # 0)
7199
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MASSACHUSETTS UNIFORM APPLICATION FOR -PERMIT TO DO PLUMBING
(Print or T pe)
bass. Date l/V 206Li�—
P rmi #
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Building Lo ation Owner's am
Type of Occupancy
New 0 Renovation 0 Replacemente",
Plans Submitted: Yes ❑ No Cl
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1ST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOR
nstalling Company Name
4ddress
FIXTURES
SEWER #
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Check ong: Certificate
❑ Corporation
❑ Partnership
trm/Co.
I1NZ UMANIa cUVERAGE:
I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142.
Yes L, No . 0
If you have checked rtes, please indicate the type of coverage by checking the appropriate box.
A liability insurance policy Other tVDe of indemnity n o a
OWNER'S INSURNACE 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.
Signature of Owner or Owner's Agent
Check one:
Owner 0 Agent ❑
iereby certify that all of the details and information I have submitted entered} In above application are true and accurate to the best of
y knowledge and that all plumbing work and installations performed nd r the permit iss for this application will be in compliance with
I pertinent provisions of the Massachusetts State Plumbing Code a tE142 ofithe eCieral Laws. _ /
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Sitrna'fure of Licensed lumber
Type of License: Wasterr ❑Journeyman
License Number
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Check ong: Certificate
❑ Corporation
❑ Partnership
trm/Co.
I1NZ UMANIa cUVERAGE:
I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142.
Yes L, No . 0
If you have checked rtes, please indicate the type of coverage by checking the appropriate box.
A liability insurance policy Other tVDe of indemnity n o a
OWNER'S INSURNACE 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.
Signature of Owner or Owner's Agent
Check one:
Owner 0 Agent ❑
iereby certify that all of the details and information I have submitted entered} In above application are true and accurate to the best of
y knowledge and that all plumbing work and installations performed nd r the permit iss for this application will be in compliance with
I pertinent provisions of the Massachusetts State Plumbing Code a tE142 ofithe eCieral Laws. _ /
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ry/r'Town i
i P.PPROVED (OFFICE USE ONLY)
Sitrna'fure of Licensed lumber
Type of License: Wasterr ❑Journeyman
License Number
Date. k
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING.
This certifies that ... .............
has permission to perform
plumbing in the buildings . ...... ............
at. No Andover, Mass.
Fej,5". Lic.
INSPECTOR
Check #
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type)
Mass- Date KOermit # _
�I Cha c7
Building Location p Owner's Name
Type of Occupancy Resident 1
New ❑ Renovation ❑ Replacement 09 Plans Submitted: Yes ❑ No ❑
FIXTURES
Installing Company Name Heritage Htg . &Plg . Co. Inc. Check one: Certificate
Address 35 Pleasant Street EX Corporation 7.14
Stoneham, Ma 02180 ❑ Partnership
Business Telephone 781 — 4 3 8-77 76 n Firm/Co.
Name of Licensed Plumber Gordon Switzer
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 have checked yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy IN Other type of indemnity ❑ Bond ❑
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:
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 the permit issued for this application will be in compliance with all .
pertinent provisions of the Massachusetts State Plumbin ode and Chapter 142 di the General Laws.
By
Title gnature of License lum er
City/Town Type of License: Master Journeyman [3APPROVED (O FICE USE ONLY) License Number 8 3 2 2
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Installing Company Name Heritage Htg . &Plg . Co. Inc. Check one: Certificate
Address 35 Pleasant Street EX Corporation 7.14
Stoneham, Ma 02180 ❑ Partnership
Business Telephone 781 — 4 3 8-77 76 n Firm/Co.
Name of Licensed Plumber Gordon Switzer
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 have checked yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy IN Other type of indemnity ❑ Bond ❑
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:
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 the permit issued for this application will be in compliance with all .
pertinent provisions of the Massachusetts State Plumbin ode and Chapter 142 di the General Laws.
By
Title gnature of License lum er
City/Town Type of License: Master Journeyman [3APPROVED (O FICE USE ONLY) License Number 8 3 2 2
%2" Watts 9D bfp on water line to water boiler-- ��
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Date. .%.!... �. �... `....... .
to TOWN OF NORTH ANDOVER
' PERMIT FOR GAS INSTALLATION
D
This certifies that. ..r...l. ..! :�'.`.�.... !,.f . `{..............
has permission for gas installation .........................
in the buildings of ..:..' .....................................
at ................................ North Andover, Mass.
Fee......... Lic. No........... .........:.................
GAS INSPECTOR
c
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO GAS FITTING
or print) Date / a Py/06 W
fH ANDOVER, MASSACHUSETTS
ins 15- V/ 1 -e y G/ .
Permit # 3 yJ-0
Amount S '30.
DlvC/%i�L►/
Owner's Name
%I1C�if�R/J ysn/ioSs y ,
�—�
New
❑
Renovation
❑
Replacement
r
t
Plans Submitted
❑
(Print ortype Check one: Certificate Installing Company
Name , Lo,,QA9 4zapf41^1Cy
❑Corp.
Address P111 O' /jam 572— ❑ Partner.
^q o/X Vz
Business Telephone i7b' `� �r,.j so ci/ ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes No ❑
it have checked yes• please mdtcate the type coverage by checking the appropriate box.
Liability insurance policy ❑ Other type of indemnity ❑ 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:
Sisnature of Owner or Owner's A:7 Owner F1A-ent ❑
( 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 periormed under Permit Issued For this application will be in
compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
By:
Title
City/ Town
A,PPROVED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
0 Plumber 2 y-Yj�?
❑ Gas Fitter ;cense iNumoer
❑ Master
i''C7 Journeyman