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HomeMy WebLinkAboutMiscellaneous - 175 STONECLEAVE ROAD 4/30/2018DEPARTMEINT OFPUBLICSAFAW BOARD OF FIRE PREVEW0NREGUL 47Y0AN 527 CMR 12-00 No. 30`7/ & Fees Checked APPUCATTONFOR PFRAff TO PERFORM ELECTRICAL WO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL. INFORMATION) Dat 1 b Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 1 –7,5— S "� o r,- C (-P_ - R_ &_ To the Inspector of Wires: Owner or Tenant `4- 0 1c– Owner's Address Is this permit in conjunction with a building permit: Yes M No (Check Appropriate Box) Purpose of Building S Utility Authorization No. Ga 1�1. Existing Service Amps I�Sqj-Volts Overhead Undergrounds New Service +� Amps�Volts Overhead Underground Q Number of Feeders and Ampacity 'I.- - Z- Ce, Location and Nature of Proposed Electrical Work No. of Meters No. of Meters No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool AboveBelow Generators KVA ground ground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices LocalMunicipal Other' No. of Dryers Heating Devices KW Connections No. f Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER' 0M101 b®c. INKRAN E LJ BOND ED allER F 3 0 WoikIDStld 8' �_.... ?tgxd6D*RepmWd Signed underlie I'dmllim ofpa�wy FIRMNAME ----41 lartwaguvak YES M NO M If�c uba%edxckedYlr,,plemmdc*lhe=Wcfw&aWbydxdcwgtbe Est&dvahieotEkc txd Wodc $ Rao Falai . Q. Gc.A (,J,, Z Lloe m ©. Sigrr ti 77V 7f-1 s,rI AddiQ. – h Y �4 . C, /-> ;;,-4 C --� , Gvi A AILTe1Na OWNER'SWSURANCEWANFR;I.ammvatethmheldamput cutr�toeca t�rilsst> >lialec�riva �tegtmedbyM se�sGmea(Cavus andthatmysig�taeonthsp�app�env�sthisiec�taatxat. (Please check one) Owner a Agentf Telephone No. PERMIT FEE $ / J No 3 2 l 9 Date. ... .......... NORTH TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING -1 CMU5� This certifies that ......�...... ��`f .1'. 1 . y. L........ .............................. has permission to Perform....................................Al f � >..c..r..r...�.... ............. wiring in the building of ....C/, ,. //, ............................................................... .... !...........C.far:4..'c.`£... °.....�......../,North Ando*er;Mds. Fee. 5..: Lic. No.l...IRR ')..........! .... .......... /ELECTRICAL INSPECTOR Check N �` G "Z WHITE: Applicant CANARY: Building Dept. PINK: Treasurer .:e Camr,:orzweatth of :�fcssachrlse:�.� � �' Depar mezt of?Sefey rCARO OF 11 -I G PRCYEIICV . .alfeefvals��.ne:�0s . p M`�i�.i A°CLiC `.i f0N FOR PERIMIT TO PER=ORM =; =r^^ICAL INORK M work ;o b•e pc6cemed 1n aecordar.:e with the M&wchuscru c:ce:rjeat Csee...7 CMR '—*00 (, ZAS_ ?R -TY: MI :M OR 71-1-2S Data C C -,.y or :oc.-a of�nr�»2It - e undersLsned applies for a peri; ;o ,er=ora the electrical vork described Jelow. Location (Street a :EL—ber) % Ot-ner or =e:anc Owner's Address Is this ?e _it in conjunction vith .a bui:diag p•e=i:: Yes ❑ .,to (C~.eck Appropr.ate Sox) ?tiirpose o: 3uLldiag v 4 0 jj Utility Authorization NO. Z:,isting Service Aps / Volts Overhead ❑ Undgrd ❑ No. of ?kters 2tev Se: -rice laps / Volts Overhead ❑ Undgrd ❑ No. of :fete: Number of Feeders and Ampaeity. Location and Nature of ?roposed Zlee:rival Work Q No. of Lighting Outlets I No. of Hoc Tubs (NO. of Transformers TXYA� No. No. of Lighting FixturesAbove of Receptacle Outlets Swimming ?ool I" grid. ❑ Igrad. Cl No. of Oil 3urners IGenerators 1C9'A No. of aergency Lighting Battery Units :,�1• r� NO. of Switch Outlets No. of Cis 3urners IFIRE A1.VM No. of Zones No. of Detection and* Initiating Devices No. of Sounding Devices g INo. of Self Contained Detection/Sounding Devices Local ❑Ysinicipal []OtherConnection � • ' No. of Ranges Ito. of Air Cond. Ioul No. of Disposals INC.ons No. of Heat local Poul PUMos Tons RN No. of Dishwashers Space/Area Heating l No. of Dryers I Heating Devices AW No. No. of nate: Heaters XW Hydro Yassage :fibsI I No, of No. or. Suns 32111sts No. of :SOCOT3 Total H? I Low Voltage I " • .•.:' OMaR: SPR? 1 9 PO' INSURANC- CCVMG-z: ?uTsuant to the requirements of vassschuset;s General Laws I have a c_rrenc Liability Insurance h licy including Completed Operations Coverage or its substantial equivalent. TZ..SCJC NO ❑ I have submitted valid proof of same to this office. TXESQ NO ❑ If you have checked IMS, please indicate the type of coverage by chec:cing the apgreprizte box. INSURAHC: 91 BOND ❑ OTM ❑ (Please Speci.y) Estimated 'lalue of "Sleetrieal Work S (Zxpiracion atel Work to Start - ' 17 Inspection Dace Uquested: Rough Final W I I ` C I SLgred under the penalties of perj:iry: FINK :�A.w_ M. �'�.3U. BURNS EVvr. I :CAL CC"IT AC -M .3. T" C LIC. No. -k707'7Licensee �LARTIN IV. BURGS �,� Sigratnre��� • _,�•' LIC. N0. �6 Canal Tel 396'-!p3o7 Address J `'` �� `• Sus. No. - . �..... � .: .�� : Alt. Tel. No. C..',`lE2'S i:1SL'?.i1Cz ::Ai'lER: I as aware,. hat the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts Central Laws, and tnac my signature on this permit application waives this requirement. Cvner Agent (Please check one) _- Televhone No. PES r= FET S 1Z"`� MASSACHUSETIN UNDDRM APPLICATON FOR PERMIT TO DO GAS I MING (Type or print) �Da e 1 NORTH ANDOVER, MASSACHUSETTS Building LocationslGr, L�� e by Permit # % � ount $ Owner's Name New Renovation Replacement 1•J Plans Submitted ❑ (Print or type) \ - j ff one: Certificate Installing Company Name �'� c. c��1� . z���� Corp. c Address ,�"�'� ❑ ParMer. BuLiness Telephone ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check I have a current liability Insurance policy or it's substantial equivalent. Yes E3 No❑ If you have checked M please y tate the type coverage by checking the appropriate box- Liability ax Liability insurance policy 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. Signature of Owner or Owner's Agent i hereby certify that all of the details and information I have best of my knowledge and that all plumbing work and instal compliance with all pertinent provisions of the Massachus,0 (OFFICE USE ONLY) Agent ❑ K entered) in above application are true and accurate to the mmed under Permit Issued for this application will be in Code and Chapter 142 of the General Laws. S gnature f Licensed Plumber Or Gas Fitter Plumber `-m -Y Nt Gas Fitter License Number Master Journeyman a�290 wwwwwwwwwwwwwwwwww�ww�w �wwwwwwwwwwwwwwwwwwwww , , • wwwwwwwwwwwwwwww■www��wwi , • wwwwwwwwwwwwwwwwww�ww■w wwwwwwwwwwwwwwwww�w�wiww wwwwwwwwwwwwwwwwww�www • , • wiwwwwwwwwwwwwwwwwwiw�ww , • wwwwwwwwwwwwwwwww�wwww , , • wwwwwwwwwwwwwwwwww�www� o, www��wwwwwwwwwwwwwwww (Print or type) \ - j ff one: Certificate Installing Company Name �'� c. c��1� . z���� Corp. c Address ,�"�'� ❑ ParMer. BuLiness Telephone ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check I have a current liability Insurance policy or it's substantial equivalent. Yes E3 No❑ If you have checked M please y tate the type coverage by checking the appropriate box- Liability ax Liability insurance policy 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. Signature of Owner or Owner's Agent i hereby certify that all of the details and information I have best of my knowledge and that all plumbing work and instal compliance with all pertinent provisions of the Massachus,0 (OFFICE USE ONLY) Agent ❑ K entered) in above application are true and accurate to the mmed under Permit Issued for this application will be in Code and Chapter 142 of the General Laws. S gnature f Licensed Plumber Or Gas Fitter Plumber `-m -Y Nt Gas Fitter License Number Master Journeyman a�290 -16 Date...... I.A. TO 2226 - d4 HORTM TOWN OF NORTH ANDOVER Q o p PERMIT FOR WIRING 4 SACMUSUi ES '~ z?u 2 hS ! le c /f?,, L Thiscertifies that............................................................................................. has permission to perform ...... W.. M.04�4.................................................... wiring in the building of .................................................... at.......,...UnQ....1.`�.g�-............... , North Andover, Mas* Fee0 ' 0� Lic. No.......................................................................... ..................... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File 2-- Date /x- ..... . e .......... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .......................... has permission for gas installation ................ in the buildings of . . ...................... ............ ...... North Andover, Mass. Fe& -4? Lic. No.' * GAS'*NS INSPECT. Check # /�/\S 4187