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HomeMy WebLinkAboutMiscellaneous - 160 ANDOVER BY-PASS 4/30/2018 (3) �--g�� u Y � f Date.. . . .. . .. .. .. . . . i H°RTH � � O TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION SACHUSES . ° �r This certifies that, . . . . . . . . has permission for gas installation ./�. .�. i�f'. . . . . . in the buildings of,(..,rl.: ���f � � . . . . . . . . . . . . . at ./. �� orth Andover, Mass. . Fee" ."�U. Lic. No.. �Y . J. . . . . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR Check# ! 5017 i MASSACHUSETTS UNIFORM APPLICATO FOR PERNU TO DO GAS FTMNG (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations w el ��S Permit# ✓ v/� _ieAmount$ r's Name �1 S r rIA New© Renovation ❑ Replacement ❑ Plans Submitted ❑ x a U z w w o o H x a z o w F a z ° z W 90w o a s > Q Cnrx z U [� a w W H A F �: H z F z H H w ° o w H a CO z � z a o °o w W E-4 O x w D A t7 a U C4 A a H O SUB -BASEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR I 6TH . FLOOR 7TH . FLOOR STH . FLOOR (Print or type) Check one: Certificate stalli Company Name r Corp. S Address � fie' ❑ Partner. Business Telephone 117 % 7vo 0 ❑ Finn/Co. Name of Licensed Plumber or Gas FitterL-- INSURANCE COVERAGE Check one: . I have a current liability Insurance policy or it's substantial equivalent. Yes ® No❑ If you have checked yes,please indicate the type coverage by checking the appropriate box. Liability insurance policy M Other type of indemnity ❑ Bond ❑. i 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: Signature of Owner or Owner's Agent 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 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. Signature of License4PIr Or Gas Fitter BluePlumberCity/Town ❑ Gas Fitter er Master �' APPROVED(OFFICE USE ONLY) ❑ Journeyman pp i Date.. ... NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSACMUS� � This certifies thatFL....�...e.....A... 'Pa has permission to perform ....Agpp.f ..... 1r��'AJ< ..................... C�f�R .S /f��A f'A'T wiring in the building of i at........&Q...ANv1�4...lzv.:�1sS...........r...,North Andover, ,MMass. Fe...,S-�:...... Lic.No., ` ..... r, l ......................... ELECTRICAL INSPECTOR Check # 5562 Th'CO7DE ;NCE T Q LUS,S'4CHUSETIS Office Use only OF IlCSAFElY Permit No. BOARD527 CM 12:010 Occupancy&Fees Checked APPUCATTONFOR TO PERFORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORTHE MASSACHUSSTS ELECTRICAL CODE,$27 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORM Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) 160 Owner or Tenant C rZ S T-6%>?a a Owner's Address S, 0,VVt.e_ Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Am%— Volts Overhead Underground No.of Meters New Service Amps / Volts Overhead Underground No.of Meters Number of Feeders and Ampacity i Location and Nature of Proposed Electrical Work <t vh 0 —5ew�2ry No.of Lighting Outlets No.of Hot Tubs No.of Transformers 'Total KVA No.of Lighting Fixtures ��✓ Swimming Pool AboveBelow Generators KVA round round No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units 'Nlo.of Switch Outlets ` No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones I Tons No.of Disposals No.of Heat Total Total No.of Detection and _ Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER• h,stnanWCovaage.RMauttothetequrcarEMofMasswhusMGar nal Laws IbawacuuaiLiabihtykoxmmPohcymcltxlTGmipleo,- cusCovwdgecril wbsrmltia apvalent YES ® NO Ibaveabmimdvalidploofofsametothe0ffim YES IfyoubawdEdgedYES,plea9eilxli&tbetypeofcovaageby chaddngthe box INSURANCE BOND OTHER (PleaseSpeafy) ID FxpnatiorlDate EZmated VahteofFlachical Work$ Work toS A h>spedionDateRapested Rough Final Signed underlie Ruiallies of pequly FIRMNAME YIAC In Cv4 J A-CVC> 6 (ee-1 V <- Ii eNo. 7S!/6S E li�>SeeJN1�G�ct2�l � lA c-PD Sig A. c liCM90No 3 7 5 y�rc / BuSinessTeLNo. 17Sr-670 Arklirec J / r''v+�OV�-� �L tom- C l�y�cClq r VV' �o Z' Ah Tel.No. X81-353 `�3/ OWNER'S INSURANCE WAIVER;I am aware that the Lime does not have the m%mm coverage orits substantial equivalent as mgmed by Mas�Geist Laws and that my signature on this peanitapplication waives this rows ar>ertt (Please check one) Owner F-1 Agent F-1 q ✓� Telephone No. PERMIT FEE$ ©•�•✓ �ijgnature Or caner or Agent TRE COA ONWFALOF MASS4CHU,SE+77S Office Use only DEPAMM0FPUX1CS4FETY permit No. ���- BOARDOFFMPREVEMONREGUTAHONS527O R12M Occupancy&Fees Checked APPLICATIONFOR PERMIT TO PERFORMELECTRICAL WORK �'� ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 2, 9- 0Y 2 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) Gj 0 t-t V\Lie _SS _ Owner or Tenant C i�R", o` Owner's Address Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building �tity Authorization No. Existing Service Amps _Volts Overhead Underground r N of Meters Ma,� New Service Amps volts Overhead r 'Underground No:of Mets Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work <c 0 A.e.A �Sew.�.�T' No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures ✓ Swimming Pool Above Below Generators KVA round 1:1round No.of Receptacle Outlets / No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets ` y No.of Gas Burners o,of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal � Other Connections No.of Water Heaters KW No.of No.of Si ns Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER' kW0KeC0WrW-Putsi"lDthetegtmanaY.sofMas XhuMGff0WLaws Ihawaamartliab&yhm==Pblicymdxkg(DmT!2 Cc)wr eorilsabs=Wegtrivalent YES ® NO IhavembniwdvandptoofofsmmtodeOffioe.YES I/ ffyoubavechedadYES,pkmenbcatethetypeofcoverageby chedangthebox. INSURANCEBOND OTHER ftaseSpeccfy) Estimaled ValueofEbctical Wolk$ WorktoStatt kMacdonEaleReque9ed Rough Final Sigtlad underlie Punyes of FIlZMNAMEc.ln Cv4 J�9� 17Z� (ea I vCi LicerrseNo. 3 75 yS"E— Li.—INt,C;lnc�e l v�1(A-c.PO SignaWre Iice=No 3 7 9` i C BusmessTel.Nb. ti'7y-G7G-/ ,Sib '�� J / IvYtOt�-� �L t�J� J7 �2��C►4i VV t yr t!�Jo Z 1 Alt Tel No. t✓�vfR'SINSURANCEWANFE;IamawatedrLtheLioawdotsnothavetheinstuanoeoovaageoritsa*stanea Nmvalatas byMffimdmsemGe Wlaws and thatmysig iahueonthispemaappbmlionwaivesthisregtmerneit. (Please check one) Owner Agent Telephone No. PERMIT FEE$ LJ S•✓ Signature ot Uwner or Agent 7 �. �I \J s�� � �- � � �� � 1 ._.,�