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HomeMy WebLinkAboutMiscellaneous - 175 WEYLAND CIRCLE 4/30/2018P I)c urttncut of Public eufct _ V � U g BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only Permit No. go Occupancy ,& Fee Checked 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date City or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 4. /_3c) � �J ;V ��Ql� C41,dyi Owner or Tenant Owner's Address Is this permit in conjunction with Ek building permit: Yes el- - No ❑ (Check Appropriate Box) Purpose of BuildingS �Te �u-e�%��i Utility Authorization No. U 1 /8 Existing Service Amps—J Volts Overhead EJUndgrnd ❑^ / No. of Meters New Service 2-20C) Ampso Volts Overhead ❑ Undgrnd LcX No. of Meters Number of Feeders and Ampacity A ' Location and Nature of Proposed Electrical Work ,y ec,,L/ No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained No. of Ranges No. of Air Cond. Total tons No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices LocalMunicipal ❑ Other ❑ Connection No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws �� I have a current Liability Insurance Policy including Compl d Operations Coverage or its substantial equivalent. YES do NO ❑ 1 have submitted valid pr of of same to the Office. YES�O ❑ If you have checked YES, please indicate the type of coverage by checking the appiwfiate box. INSURANCE el BOND ❑ OTHER ❑ (Please Specify) (Expiration Date) Estimated Value of flect icaI Work $ _ Work to Start r" Signed under the enalties of perjury: FIRM NA Licensee Address Inspection Date Reguesled: Rough el Final NO. !� LIC. NO. Bus. Tel. No. _lam �4/6 Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or Its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner. Agent (Please check one) I f�JIVI Telephone No. PERMIT FEE $' "" (Signature of Owner or Agent) ,,.araa ` Date .... 1.. .. 2982. NOR7F °'•"`°;a�"° TOWN OF NORTH ANDOVER GL p PERMIT FOR WIRING ,SSACHUSES This certifies that ...1 ......... E.4.....� : �.�................. has permission to perform ...... �v �. ...........).!. v.'^ ! e ............................ wiring in the building of .4ti� �cJ�......... C�t. q .:....................... i, 01- U at ................. //�.......... C.!. R ..:........... . North Andover, Mass. Fee.... 2 �..:��.. Lic. No..1.(..��............................................................... ELECTRICAL INSPECTOR (. � " py)y WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File I� rw��aa.7c I r a unir'unm Ar rut.#Af tun tufa f tflmr r r u uv r s.�+�.��+��•�+ (Print or Type) 31 j NORTH ANDOVER, , Mass. Date - Z ...to BuIlding tt Permit # 2� 27 Location Iron l �V �lr'd J4 1 r7 Nims a �— iVy c New Er Renovation ❑ Replacement ❑ Plana Submitted: Yes ❑ No. ❑ FIXTURES Check one: Certificate Installing Company Name Qocj I F v` rIA, EKorp. 44506' Address n O�, a b c l Z v\ ❑ Partnership 0AU th U CL 4- ❑ Firm/Co. Business Telephone �)i Lc-rz Y, Name of Licensed Plumber _ Ys --e t -x- 6*L &i 4 INSURANCE COVERAGE: Mack one 1 have a current liability Insurance policy or Its substantial equivalent. Yes ❑ No ❑ If you have checked 3M, please Indicate the type coverage by checking the appropriate box A liability Insurance policy ❑ Other type of Indemnity Cl Bond ❑ I. OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 112 of the Masa. General Laws, and that my signature on this permit application waives this requirement., Check one: Signature of Ovnet or Owners Agent Owner ❑ Agent [I 1 hereby cwUfy that al of the detags and Inlormation 1 have submitted for entered) In above application are true and accurate to the best of my It and that all pplIumbing wak and Inslalatlons performed under the pemril Issued for this application will be lana with all pertinent provisions of thi Massachusetts State Plumbing Code and Chapter 142 of the Ctty/Town APPMVED (OFFICE USE ONLY) Signature of Ili—wsedum r License Number ����`7 F Type of Plumbing License: Master [t} Jowneyman ❑ " Date. T, 2889 o'<He °T �'"v TOWN OF NORTH ANDOVER ' PERMIT FOR PLUMBING S ,S.1 CHUSEt This certifies that .�� 1041lilmfIkppd h ................... Pi has permission to perform ... A/ c ................ t,c. plumbing in the buildings of ..�. R T ....................... o, at. I i.....North Andover, Mass. Fee 3� .... Lic. No. !P 3 Y � . ...... LUMBING INSP CTOR WHITE: Applicant CANARY: Building Dept PINK: Treasurer GOLD: File MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT T4 DO GASFITTiNO (Print or Type) l NORTH ANDOVER Mass. Date__ Lf Z� _s 4uilding Location /-63 3 j�� Permit # —2-17 LOwners Name New , —C,'Renovation Replacement Plans Submitted • 1 r� L 7a (Print or Type) Check one: Certificate Installing Company Name Jam' Corp. 0'0(� Address 60-0, 0 o jo 17c) /-7 � Partner. /-My4tuGL LA,4A OlQ3 / F—f Firm/Co. Business Telephone: 02 y — ( Ice 5 Name of Licensed Plumber or Gas Fitter Sj-r— .Q • • • V • OEM MEMO MMMIMIMM■»ME- ME ■�O��i�■©��O�SOON MOs»IM»' noun (Print or Type) Check one: Certificate Installing Company Name Jam' Corp. 0'0(� Address 60-0, 0 o jo 17c) /-7 � Partner. /-My4tuGL LA,4A OlQ3 / F—f Firm/Co. Business Telephone: 02 y — ( Ice 5 Name of Licensed Plumber or Gas Fitter Sj-r— .Q Insurance Covera e: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy EJ' "cher type of indemnity F --j Bond �( Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner u Agent El I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true end accurate to the best of my knowledge and that all plumbing worst and installations perfornud under' Permit issced fo: this application will -be in compliance with all patinent Provisions of tho Massachusetts State Cas Code and Chapter 142 of tho Genual Laws. By E LICENSE: C FMasrneymanter mber Title fitter, Signature of Licensed City/Town: Plumber or sfitter APPROVED (OFFICE use ONLY) Lic(eYrsZY I umber 1 `.° 2172 NORTH 14,m O � A � s SSACHU5Et Date ... / ....... i ........ . a TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATIO&' M This certifies that fes.. `!h. C .�.:........II ? . ............. �. has permission for gas installation ..%L t ...... . in the buildings of ..T. .......................... . at ....... North Andover, Mass. Fee..? ." .. Lic. No. l ?. `.i r... ......................... . GASINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File Location W� No. - Zj Date , 02/02/96 11:57 .- 9413 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL (1,�) $ Building Inspector 17272.00 PAID Div. Public Works Location No. _ r _ Date ��' 20— T�,�a TOWN OF NORTH ANDOVERa Certificate of Occupancy $ 9 n Building/Frame Permit Fee $ _ o ��s'••°'''�� SACMUSE Foundation Permit Fee $ .. Other Permit Fee $ /U Sewer Connection Fee $ t Water Connection Fee $ y TOTAL $ � � uil g Ins c to 95 11:29 �,,:�.00 ' _,.,..•--�"'"-� PAID / Div ubt c Works Location t1 �A430 q No. — (OCO Date 74 Iq r t TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL rj) $ �_ Building Inspector 9"12 i „ "12 150.00 PAID a - Div. 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CL O W to b n• to O O a O 9 t" w v )Mq 0 0 c FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: �®iC W 0 0 �`P a C4 Phone LOCATION: Assessor's Map Number Subdivision s X W COO( Parcel Lots) �_?o Street L,0_� 4 /an d Cc,-GlP St. Number ************************Official Use Only************************, RECOMMENDATIONS OF. W7T0//77-' Conservation Admini trator Comments i x LL) - Town Planner Comments Food Inspector -Health In Septic Inspector-HealthA o Comments Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved' Date Rejected Public Works - sewer/water connections -Iq`ti 11-7o,47-5 - driveway pepnit 117l W) 1l- 19-/ Fire Department eived by tuil'ding Insp'ector Date ®AF® W -A G. Wit. • V . 40 P� a P.• N 7 w � TFr•3�D� � ' , Zy _ T/VE AND SPEC/AL PERM/T PLAN ' WOOD, . � -• .... .- .a _ .. . . :_ - :erg � A. ,n �` ....t, ea •,t _ TH, ANPDVE R .MASS A tM rt L . r RFT �.RF_ALTY}�TRUS. � �Y „. •.4'c- '�cS. ..�.. sQ a. 5 7MRWINE STREET SUITE 2091. IV ORM ANDDi!EJ4, M� • -..rte • L `S � i .. �� . � - Wit. • V . 40 P� a P.• N 7 w � TFr•3�D� � ' , Zy _ T/VE AND SPEC/AL PERM/T PLAN ' WOOD, . � -• .... .- .a _ .. . . :_ - :erg � A. ,n �` ....t, ea •,t _ TH, ANPDVE R .MASS A tM rt L . r RFT �.RF_ALTY}�TRUS. � �Y „. •.4'c- '�cS. ..�.. sQ a. 5 7MRWINE STREET SUITE 2091. 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