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Home My WebLink AboutMiscellaneous - 187 STONECLEAVE ROAD 4/30/2018 (2)11 N MASSACHUSETTS UNIFORM APPUCATON FOR PERMUT TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations New E7 Renovation D' Date' ?C'L eACYP,. K C1 Permit # Amount $ 7yl Li.Owner's Name Replacement Plans Submitted (Print or type) Name Name of Licensed Plumber�or Gas Fitter LLC L4 Checne: Certificate Installing Company Corp. Partner. Firm/Co. INSURANCE COVERAGE Check one I have a current liability Insurance, policy or it's substantial equivalent. Yes No[3 If you have checked Les, please indicate the type coverage by checking the appropriate box. Liability insurance policy [:] Other type of indemnity 1:1 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: Signature of Owner or Owner's Agent Owner 13 Agent 13 1 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 Massachsits Stat"f Code and Chapter 142 of the General Laws. By: . Title y City/Town, APPROVED (OFFICE USE ONLY) Jgnature of Licensed Plumber Or Gas Fitter Kmber / 30 Gas Fitter License um er Master Journeyman w a U vi W W C O C z F W z U x z F C C G > W F z F Z H W w V p > t: W U a > x Z d e c °o w SU B-BASEM ENT U C > O 4 FS O BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR (Print or type) Name Name of Licensed Plumber�or Gas Fitter LLC L4 Checne: Certificate Installing Company Corp. Partner. Firm/Co. INSURANCE COVERAGE Check one I have a current liability Insurance, policy or it's substantial equivalent. Yes No[3 If you have checked Les, please indicate the type coverage by checking the appropriate box. Liability insurance policy [:] Other type of indemnity 1:1 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: Signature of Owner or Owner's Agent Owner 13 Agent 13 1 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 Massachsits Stat"f Code and Chapter 142 of the General Laws. By: . Title y City/Town, APPROVED (OFFICE USE ONLY) Jgnature of Licensed Plumber Or Gas Fitter Kmber / 30 Gas Fitter License um er Master Journeyman Date ..(V-1 , A J.-- .... . a TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATK This certifies that .!:.` . � ............. has permission for gas installation CT .. J'/!r.:: t......... . in the buildings of . 6f. "9:4.E. ............................ at ......... North Andover, Mass. Fee..��..'.. Lic. No..��.�!�3. QQr ........ GAS INSPECTOR Check # ) 7 • 1 s i� �.otnmoruuenli�� o�./rlril4nc rueH.! 4. -it *: �eparlmrnj o�•-7'irc ervitc9 ' BOARD OF FIRE PREVENTION REGULATION'S F_____Officill Usse Only ` Permit No. _ `541 _ Occupancy and Fee Checked (Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perforned in acrl.dance with the Massachusetts Electrical Code (MEC); 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL IIS 0D 1&1 TION) Da f e .> ' C;U_/d City or Town of: A409-7-79 To the Inspector of Wires: + By this application the undersigned elves notice of his or her intention to perform the electrical work described below. Location (Street & Number) ��/1 v Owner or Tena nt`s--� Telephone No. Owner's Address v Is this permit in conjunction with a building permit'? Purpose of Building Existing Service Amps / Volts New Service Amps Number of Feeders and Ampacit) /I Volts Location and Nature of Proposed Electrical Work: Yes ❑ No (12heck Appropriate Box) Utility Authorization No. Overhead ❑ Overhead ❑ Undgrcl ❑ Undgrd ❑ No. of Meters No. of Meters S_7`eA n_ - _r_,r_._ r,l. a it ,., r.,hia .,, ha hu Ihv lnsaertor of li'ireS. rI IIGC'll G(lLIIIUn(u nl'mu r� uc�n cu, u ,,., ,. y,.,•.,..., ... ...,1....... _� .... __. Estimated Value of E ectrical Work: (\'then required by municipal policy.) Work to Start: Inspections to be requested in accordance with MCC RUIc 10, 111d '.11)01) completion. INSURANCE COV-CRACE: 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 equivslrnt: The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuin_ office. CHECK ONE: INSURANCE N BOND [IOTHER ❑ (Specify:) / cerlify, antler the pains and pellnllies of perjury, that IIIc infnrnlnlina nil /his npplic•Gliuu is trite (incl complete. /5 C— FIRM — FIRM NAME: ��% �� t✓ur l _ L,C. NO.: Q�L�� / Licensee: ) t Signature �`�''� I.IC. NO.:S1Z_Z ) 0fopplicoble. enler "esenl]lryl the 'FeL11n�167et�hi�lle.2r 1�,1/ISS �t7 G Bns. fe!. Nei.: 3• �/5�� 1 Address: /lass �1� �% All. Tel. No.: 'Per M.G.L. c. 147, s. 57-6I, securi r work requires Department of Public SIIfely "S" License: Lac. N,0. ,Ss C2 OWNER'S INSURANCE WAIVER: I am aware that the Licensee sloes not have the liability innrrancc covers,^_ narmslly required by law. -By mysignature below, I hereby waive this requirement. I am the (check one) ❑ 0%,.net ❑ owner's ae.er.t. Owner/Agent I'I'IZlllll'FL't�: S ,` Signature Telephone No. ._ _ •7_� No. of foist No, of Recessed Luminaires No, of Ceil.-Susp. (Paddle) Fans Transformers I(VA No. of Luminaire Outlets No. of Hot Tubs Cenerators KVA Above In Pool ❑ ❑ o. o mergency ,g lting No. of Luminaires Swimming grnd. grnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Detection and No, of Switches No, of Gas Burners Initiating Devices No. of Ranges No. of Air Cond. Tonsl No. of Alerting Devices Heat Pump N.umer Tons iC\\� No, of elf -Contained No. of Waste Disposers Totals: Detection/Alethia Devices No. of Dishwashers Space/Area Heating KW �'lunlclpal Other Local ❑ Conne n No. of Dryers Heating Appliances KW Security Syste s: i\o. of Dev es or Irva.ent No. of Water I(W No. of No. of Data \Viring: I-leaters Signs Ballasts No. of Devices or C uivalent TCICCOmmUnleahonS \\'i ring: No. I-lydromassage Bathtubs No. of Motors Total 1 -IP No. of Devices or E uivalent OTHER: /9 7 rI IIGC'll G(lLIIIUn(u nl'mu r� uc�n cu, u ,,., ,. y,.,•.,..., ... ...,1....... _� .... __. Estimated Value of E ectrical Work: (\'then required by municipal policy.) Work to Start: Inspections to be requested in accordance with MCC RUIc 10, 111d '.11)01) completion. INSURANCE COV-CRACE: 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 equivslrnt: The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuin_ office. CHECK ONE: INSURANCE N BOND [IOTHER ❑ (Specify:) / cerlify, antler the pains and pellnllies of perjury, that IIIc infnrnlnlina nil /his npplic•Gliuu is trite (incl complete. /5 C— FIRM — FIRM NAME: ��% �� t✓ur l _ L,C. NO.: Q�L�� / Licensee: ) t Signature �`�''� I.IC. NO.:S1Z_Z ) 0fopplicoble. enler "esenl]lryl the 'FeL11n�167et�hi�lle.2r 1�,1/ISS �t7 G Bns. fe!. Nei.: 3• �/5�� 1 Address: /lass �1� �% All. Tel. No.: 'Per M.G.L. c. 147, s. 57-6I, securi r work requires Department of Public SIIfely "S" License: Lac. N,0. ,Ss C2 OWNER'S INSURANCE WAIVER: I am aware that the Licensee sloes not have the liability innrrancc covers,^_ narmslly required by law. -By mysignature below, I hereby waive this requirement. I am the (check one) ❑ 0%,.net ❑ owner's ae.er.t. Owner/Agent I'I'IZlllll'FL't�: S ,` Signature Telephone No. ._ _ •7_� ,9420 ......................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................... fi46-- / ............................................. has permission to perform ....... ........ ...... ................... �3,c /-/z wiringin the building of ............................................... .4 ................................. at .... . North Andover, Mass. Fee .... V. J—=... Lic. No .D........ L.CMCAL INSPECTOR Check ff -- Department of Public Safety Ore Ashburton Place, Rm 1301 Boston', Ma 02108-1618 License: Certificate of Clearance Number. SS CC 001975 Expires: 10/09/2011 Restricted To: 00 KENNY WONG 18 CLINTON DR HOLDS, NH 030$9 >CAI v 4 1WZ12W8� / p A ✓� �Doao7S00.1L2C.Lt�1 Of�� •+••��"'t"m �\ DEPARTMENT OF kBUC SAFETY Certificate of Clearance Number: SS CC 001975 Expires: 1010912011 Tr. no: 558-0 S -License: ADT SECURUY KENNY WONG 18 CLINTON DR G— ` HOLLIS. NH 03049 COt�;1�iCllti�:LTH O: hAASIS-ACHU-SE'Tit •r L—E —GTffl f (A REGISTERED SYSTEM TECHNICIAN LS -.1_5 HIS Lr.E1:5E 10 . IKEHHY R W0NG:: - 422 FIELDSTONE DRIVE BUtiL1.11GTON - MA 01803-42.13 5966 D 0.7 3113.0 Z8407Z Tr. no: 558.0 Keep.,top for receipt and change of address notification. a M a DIG SAFE CALL CENTER (888) 344-7233 T F3 SA t, a