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HomeMy WebLinkAboutMiscellaneous - 18 HARKAWAY ROAD 4/30/2018Date....... :.lc�..... i NORTH ° ;•'"° TOWN OF NORTH ANDOVER 3: •` •. OL '0 PERMIT FOR WIRING ' CHU This certifies that ..................... ..................................... has permission to perform �' -- �'�. wiring in the building of ...:..t•-...-..°.................................................... at ..,.' .... fr.:�.: -� :.-.:-� ... , North Andover, Mass. t Fee .',A .. .... Lic. No. i 1jj � .............0, /. ' l ......... r� ELecrRtcnt INsMTR Check # 794 Commonwealth of Massachusetts f" Department of Fire Services BOARD OF FIRE PREVENTION REGULATION Official Use Only Permit No. 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 ( ), 51 C 12.00 (PLEASE PRINT IN INK OR TJPE ALL INFORMATION) Date: City or Town of: �lOt--��� �er ( To the Inspec r of Wires: By this application the undersigned gives notice of his tenttionto perform the electrical work described below. Location (Street & Number) �A )A �� Owner or Tenant /" Owner's Address PT Telephone No. 15`7 � L 7—Y?() Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building R e$'1 C.`F/V'�'ct l Utili Authorization No. Existing Service /4 0 Amps 1 0/ 2 olts OverheadUndgrd ❑ No. of Meters New Service 10 0 Amps LIP / -LqQVolts Overhead t _I Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: QA S C Amen oudiaonat detail i desireet, or as rcyuired br the tnspecror oJ'FI'irr.. 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 cov ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE JBOND ❑ OTHER ❑ (Specify:) VeCMo. ' mq-t il 01? Estimated Value of Electrical Work:(Ex iration Date) ob (When required by municipal policy.) Work to Start: % d� Inspections to be requested in accordance with MEC Rule 10, and upon completion. 1 certify, under t e p ins and per�ltiess of perjury, that the information on this application is true and complete. FIRM NAME: cHo LS �l,,Q �: L �PC,Tr►G Licensee: C, H(Lt S Cr (/f applicable, enter "exempt "in, Address: 111 ",:;A I PM I OWNER'S IN required by law Owner/Agent Signature _ Signature numbgr• . . LIC. NO.: %r3G�2--lj JRANCE WAIVER: I am aware that the Licensee does By my signature below, l hereby waive this requirement. Telephone No. t _ LIC. NO.: M Bus. Tel. No.: a Alt. Tel. No.: t have the liability insurance coverage normally I am the (check one) ❑owner ❑ owner's agent. PERMIT FEE: $ diuluttowing more mar De xrnred br the Ins tech or)•Vires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In ❑ o. ot Emergency ig mg rnd. 2rnd, Battea Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiatin Devices No. of Ranges No, of Air Cond. TonTots No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW No. of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers ; Space/Area Heating KW Local ❑ Municipal El Other Connection No. of Dryers Heating AppliancesKW Security ystems: No. of ater Ne. o No. No. of Devices or E uivalent Heaters KW o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER': Amen oudiaonat detail i desireet, or as rcyuired br the tnspecror oJ'FI'irr.. 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 cov ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE JBOND ❑ OTHER ❑ (Specify:) VeCMo. ' mq-t il 01? Estimated Value of Electrical Work:(Ex iration Date) ob (When required by municipal policy.) Work to Start: % d� Inspections to be requested in accordance with MEC Rule 10, and upon completion. 1 certify, under t e p ins and per�ltiess of perjury, that the information on this application is true and complete. FIRM NAME: cHo LS �l,,Q �: L �PC,Tr►G Licensee: C, H(Lt S Cr (/f applicable, enter "exempt "in, Address: 111 ",:;A I PM I OWNER'S IN required by law Owner/Agent Signature _ Signature numbgr• . . LIC. NO.: %r3G�2--lj JRANCE WAIVER: I am aware that the Licensee does By my signature below, l hereby waive this requirement. Telephone No. t _ LIC. NO.: M Bus. Tel. No.: a Alt. Tel. No.: t have the liability insurance coverage normally I am the (check one) ❑owner ❑ owner's agent. PERMIT FEE: $ A �� Date ...........1... 0�........ TOWN OF NORTH ANDOVER ;00 PERMIT FOR WIRING �SSACMUSE` This certifies that- ,. .�"�u �.......:................................................................. has permission to perform - f wiring in the building of ................... -�r{ ......................................................... I at .... ,...........T ................................ .....J ....... , North Andover, Mass. a , Fee ......`�........... Lic. No.�f..�.,.,Ci.........:................ ..... - ......' ELECTRICAL INSPEdMR l Check #_ 79G1 T! Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. "7% Occupancy and Fee Checked [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical CodeNEC), EC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Q City or Town of. NORTH ANDOVER To the Insectoilof Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) l 11AcV A � ►a �) �r�An Owner or Tenant rAt s ` Telephone No. Owner's Address f j� f�C���—�¢�j� L "-V© (W-4 Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Overhead L� Undgrd ❑ Overhead ❑ Undgrd ❑ Existing Service / Or) Amps Z-0/ 1-4 OVolts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: No. of Meters No. of Meters �'�cSQMe1<4 Fioa 1„ 1� F1 ^ Completion of the fnllnu» n fnhl..., a h---;-_,1 L_..I_ _ No. of Recessed Luminaires - No. of Ceil: Susp. (Paddle) Fans .�u.��u Irmjftaprui rvires. No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ o. o Emergency Lighting rnd. rnd. Baft2a Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS !No. of Zones No. of Switches 3 No. of Gas Burners No. of Detection and Wtiatin2 Devices No. of Ranges Tot No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers . Heat Pump Number .Tons KW No, of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local❑ unicipal ❑Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or E uivalent No. of Water N. of No. of Data Wiring: Heaters ( KW ti Signs Ballasts ' . No. of Devices or Eq uivalent No. Hydromassage Bathtubs No. of Motors Total HP Wiring: No. of Devices or Equivalent OTHER: �0O Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: —111(C,10 ' Inspections to be requested in accordance with MEC Rule 10, and upon completion. C INSURANCE VE GE: 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 issuinoffice. CHECK ONE: INSURANCE F]BOND ❑ OTHER E] (Specify:) g o ice. a 7�aj I certify, under the p ins anndpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: (, L J ti G LIC. NO.: r / 36 2_ --!3 Licensee: 1 `j (�, `� Signature LIC. NO.: 113 (If applicable, en er "exempt " in the license number�4 .) Bus Address: (�; lJ t Q", Tel. No.: Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Pu lic Safe "S" icense: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. ignature b e by waive this requirement. I am the (check one) V owner ❑ owner's agent. Owner/AVhl Signature Telephone No.� __7 _22 PERMIT FEE: 3930 NO 4e -s5 P -7 -el -9 PJ-� b. .tl Date. .71 •r . X ........ . NORTH OF `tD ,ti0 /•�' TOWN OF NORTH ANDOVER D � PERMIT FOR GAS INSTALLATION This certifies that . 33� I t!.'. j.... has permission for gas installation .. . h. 5 . ` F c- I- �. i, , -` in the buildings of ........................� ....... at ..71.E .f'!.��'!� ft !? �'.�!.......... I North Andover; Mass. Fee..6 .... Lic. No. 2— Z. �AS INSPECTOR Check # I ) L L 6471 MASSACHUSETTS UNIFORM AP ICATIN FOR PERMIT TO DO GASFITTING ,(L (Print or Type) 6 o� / Mass. Date 19 Permit # Building Location 'tA IQl Owner's Name (A Type of Occupancy G� New ❑ Renovation ❑ Replacement;, Plans Submitted: Yes❑ NTZ Installing Company Business Telephone / n U " 1 Name of Licensed Plumber or Gas Fitter Check one: ❑ Corporation C3. Partnership ❑ Firm/Co. Certificate INSURANCE COVERAGE: I have a current liability Insu a policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ❑ No If you have checked yes, ease indicate the type coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSU WAIVER: I am aware that the licensee does not have the Insurance coverage required by C pter 14 a Ma r s, and that my signature on this permit application Ives this requirement. JC he ne: Owner Agent ❑ 9g-natu o er r is Agen I hereby certify that all of the details and information I have submitted (or entero above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit ed for this appli n will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Ge r laws. By TMan e: Signat re of Ocensed Plumber or Gas Fitter Title License Number ty/Town APPRONEO( I NL :2ND FLOOR Installing Company Business Telephone / n U " 1 Name of Licensed Plumber or Gas Fitter Check one: ❑ Corporation C3. Partnership ❑ Firm/Co. Certificate INSURANCE COVERAGE: I have a current liability Insu a policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ❑ No If you have checked yes, ease indicate the type coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSU WAIVER: I am aware that the licensee does not have the Insurance coverage required by C pter 14 a Ma r s, and that my signature on this permit application Ives this requirement. JC he ne: Owner Agent ❑ 9g-natu o er r is Agen I hereby certify that all of the details and information I have submitted (or entero above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit ed for this appli n will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Ge r laws. By TMan e: Signat re of Ocensed Plumber or Gas Fitter Title License Number ty/Town APPRONEO( I NL J LU 16 v Z s J d O O O h H Z � J 4 � � O Z O � � s Date. .... y NORTH TOWN OF NORT HANDOVER F PLUM PERMIT BING ! f 7 0l1 S f�G11 etc G This certifies that ....I. . .. �.. ........ ..... .............. . has permission to perform ............ ............. ....... . plumbing in the buildings of .... . A A m at .../� ?� !4 !�`.r�`. �!........... , North Andover, Mass. Fee .. .... Lic. No. 2 •C S C, �. PLUMBING INSPECTOR Check # 1 1 2 7790 ss. Date_7LI . Z °limit a J Building Location f . lN�Owner's Name_ /%'j/?�;�/1(' P S� Owner Tell Type of OCcupancv New ❑ Renovation 0 Replacementc Plan Submitted: Yes CANo FIXTURES • I t - I Z a y n ce z Z F .L9 .'�a a U ¢ `� z w y z y < w' a F ' w CL11 2 v� U w 4 a7 u. = Z Z a U z a .m y d w F U> F 0 1 ❑ `� F Z °' ❑` Z Z 4 w .tee w w F p U 3 1-jwV2 o in a F w c w o _ _ -__ . LL _-_ I-ustal.l'Ylg' Cotupany Name /l/l Cliecl; onc:Certific tte Address�d L.Ell Gu a Corporaation 0 Parmershin Business Telephone ,;1 '91 ❑ Firm/Co. Name of Licensed. Plumber INSURANCE COVERAGE: I have a currem liability ins policy or its subsmtmal etlauivaient wlrich meets the Yes ❑ No requirements of MGL CIL 142. If you have checked ves. pl a indicate the type coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond p OWNER'S INS� CE WAVER: I Gener�dthat my signamr;.z I bereby cardry that ll of the details md'i and that all plumbing work and installadon the Massachusetts State Plumbin¢. Code an 13y— Title City/Town APPROVED (OFMF CE USE ONLY) a that the lit�see does_ not have the insurance average required by Chanter 142 of the Mass. I - permit application waives this reouiremsn, Check one: Diner /J� Agent ❑ forma n ve submitted (or entered) in above application are nue _and accurate to Lhe best of my lmowledee perfo r the permit slued for this tic=' n will be irxcomolianc� with all per4ne u provisiops of Chapter l o General Laws. / Signature or" Licensed Plumber. Type of License: Massmr.o Journeyman W a u. � cs • p � sparC rt: Ml Lu A6. :49arc < O '.' J W w' J Apin J W 9. S IN 96