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Home My WebLink AboutMiscellaneous - 20 ELMWOOD STREET 4/30/2018 20 ELMWOOD STREET 210/006.0-0029-0000.0 Date ............................. LORTH Of`"" " - TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHU This certifies that .................. ........... .. ............................. has permission to perform ...... wiring in the building of..... ............................. at .................................................... North Andover,Mass. Fee ............ Lic.NoJ,�'.P4.Z......... P��ELECMIC)-!�'-I'NMSP Check # 8843 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. ��Y3 _ BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/071 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME �,527 C 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER To the Insp ctor of fres: By this application the undersigned gives nonce of his or her intention to perform the electrical work described below. Location(Street&Number) ;L (p C-7 I VN LV,)0 d g+ Owner or Tenant �R�VVf p P i n UC p �.�', A-k U Telephone No.;;,r egc 45-, , Owner's Address c)-O e 1 m Lyaod R4 Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building 9 0-M f— Utility Authorization No. Existing Service 10D Amps ,O Volts Overhead Undgrd❑ No.of Meters New Service JpDD Amps /,)Volts Overhead Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 0/ -v&Al lad S .� ��145, l�h�t'�-moi:Y�1 S�r tl mC.C�. Completion of theollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.of Emergency Lignnng grnd. gmd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump I Number_ Tons KW No.of Self-Contained Totals: ................. Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ umctpa ElOtherConnection ' No.of Dryers Heating Appliances Imo' Security ystems: Na of Devices or Equivalent No.o Ater Imo' o.of o.o Data Wiring: fT Heaters Signs Ballasts Na of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications firingg: Na of Devices or uivalent OTHER: Attach additional detail i desired,or as required b the Inspector o Wires. .f 4 Y sP .Jr Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the pains andenaides of rjury,that the information on this application is true and complete. FIRM NAME: r�e, - (. LIC.NO.: Licensee: �,��-�e 5 F �,k nd �� Signatur � c ,�.�=��' LIC.NO.: ( a3 (If applicable,emelt. "exempt"in the lice se er line.) r r.� Bus.Tel.No.; Address: / �/�G Alt.TeL No.:!i 7 *Per M.G.L c. 147,s.51-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability i ce coverage normally required bylaw. BOwner/A my si ature below,I hereby waive this requirement. I am the(check one wner El owner's agent. Signature e Telephone No.qS 60,r-374 I PERMIT FEE:S6,5' t c r i yr Date;f1.{��. . . .... . 3 HORTM Of • 32 ' TOWN OF NORTH ANDOVER • PERMIT FOR,GAS INSTA- ION S^CHUSEt } k This certifies that . . . . .1�. . r . . . x r has permission for gas installation . .� . . . . . . . . . . . . . . . . . . . . . . in the buildings of 46&"�'.te. . . . . . . . . . . . . . . . . . . . . . at , North Andover, Mass. r Fee. .2..>. . . . . Lic. No.. .).?Y.t: . . J-,e... . . . . . . . . . . . GAS INSPECTOR Check# U) 6651 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) UVS—NCRTIA A- LOOLk, Mass. Date Z (� G Permit #—L)— Building Location�M btm� j Owner's Name SAI,!i O F 1006CN I A.Q0 k k �) r /� Type of OccupancI NCL , New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes[] No❑ N CC N � Y W N N N V X lC N a N Q ~ �C W W 0: O O O N = F 0 WV m ~ S Jl 0: azo z a C O � - w Q a Hm (n Om yW -W Q O > W W W N J z Q = m � W a W �' W H Y t7 H m z Q W =, Q C ~ F' ! N 0 z O z �W O X Q W > m W O Z. Q Q A j a '.Z O 0 Y u. a 3 C d -j 0 > C a F- O � SUB—BSMT. \� BASEMENT10 1 ST FLOOR �l 2ND FLOOR i. 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name BAY STATE GAS COMPANY Check one: Certificate # Address 55 MARSTON STREET �C] Corporation 1862 LAWRENCE, MA 018 41-23 1 2 ❑ Partnership Business Telephone q 7!B--68,7-1105 Exr #306 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery INSURANCE COVERAGE: I have aY usrrenntt liability ns ace policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checked res, please indicate the type coverage by checking the appropriate box. A liability Insurance policy 18( 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. Check one: Signature of Owner or Owner'sggent Owner[] Agent [I hereby certify that all of the details and information I have submitted(or entered)in abo plication are true and accur to to the best of my knowledge and that all plumbing work and installations performed under the permit i f r this application will n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Ge T of License: Title Plumber Signature of Licensed Plumber or Gas Gasfitter Cit /Town Master License Number 374-Jr Journeyman O IC S_O BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSP_ECT•ION FEE N0. APPLICATION FOR PERMIT TO,DO GASFITTING NAME & TYPE OF BUILDING s " " .. LOCATION OF BUILDING PLUMBER OR GASFIT_TER LIC. NO. PERMIT GRANTED DATE GA13INSPECTOR