HomeMy WebLinkAboutMiscellaneous - 206 MIDDLESEX STREET 4/30/2018 (2)it
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Date ............ z .......... 2 ._._
,AORT►1
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
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This certifies that �` . �t
...........................................................................................
has permission to perform .i �%e '
......................................... ............................
wiring in the building of .... ...... .............................................
at..0 'z���..f
..-.............IA45� L. M �North AEcnrdoof�ve�r,�Mass.
/Fee..:-57f.Lic. No. .?3X ............... ...C-II(.s�r
Check # L
10638
Commonwealth of massachusetts of cial use
Only
ri Nepal'fOi�ePlt o Fire Se1v Ces �EOc7s:n
_ I h 1,-22
BOARD OF FIRE PREVENTION REGULATIONS azzd Fee Checked
cave bunk
APPLICATION FOR PERMIT" TO PERFORM ELEC
All work to be perfmmed in accordance with the Massachusetts Elcgzical Code ��� an
WORK
(PLEAPMf -flVXK 0R TYPEALLINFl)R1i�gTIO �), 527 CMR lZoo
City or Town of: NORTH OVER � 'Date:
By this application the and To the Inspector of
ersigned gives nofice of his or her intenti����TelephoueNo..
al work described below.
Location (Stmt & Number) z r/ w/ — o Owner or Tenant Owner'sAddress
16 this permit in conjunction with a building perngit? Yes {�
Purpose of Building Z. L1 No L.J Wheck Appropriai Bos)
ply Utility Authorization No.
Existing Service ZelV Amps2yU'Voltr,
Overhead Undgrd ❑ No. of Meters Z -
Nevi Service s •_�'
Vts Overhead C Undgrd [] Na. of Meters
Number of Feeders and.Ampacity ol
Location and Nature of Proposed Electrics woork: r /
inspections to be requested in accordance with MBC Rule 10, and
INSURANCE COVERAGE: Unless waived by the owner, no upon completion.
the licensee provides proof of liability insurance including « Permit for the performance of electrical work may issue, unless
undersigned certifies that such coverage is ' , and �-completed operation" coverage or its substantial equivalent The
CEMCK ONE: INSURANCE
exhibited proof of same to'the permit issuing office.
I ce?Wfy, under the pains and enaNes o r OTHER ❑ (Specify. .
FIRI12 Nr1ME: p fP�jury� that the �sformahinn an thir
irpJieation rs true and completes
Licensee: r . �,,1��. ,�.� 5f°' 1 �" 1`� S' a LIC.
(If applicaU lure74
exempt ' cn the license number line.) `", y LIC. NO: s .�
Address: Bus. Tel. No.:
*Per M.G.L c. 147, s. 57-61, security work requires Alt: TeL No.:
OWNER'S INSURANCE W Public Safety "S" License: Lie. No.
A]NT1&- I am aware drat the Licensee does not have the liability
required g naw. By MY signature belobv,'i hereby waive this requirement I am the (check one) owner coverage
Owner/.Agent
Signature Telephone No.
PE.�!MIT
ELECTRICAL PERMIT NO. . -INSPECTION REPORT:
ELECTRICAL INSPECTOR - DOUG SMALL
1. ROUGH INSPECTION:
Passed - [ I Failed - [ j Re -inspection required ($50.00)
Inspectors' comments:
2. FINAL INSPECTION: "
Passed - Failed [ j Re -inspection aired ($50.00)
Inspectors' comments:
l�
(Inspectors' Signature - no initials) Date
3. UNDER GROUND INSPECTION:
Passed -�
[ I Failed - [ I Re -inspection required ($50.00) - [
Inspectors' comments:
(ins ectors' Signature - no initials) - Date
4. INSPECTION - SERVICE:
DATE CALLED NATIONAL GRID: NAME:
Passed - Failed ( I Re -inspection required ($50.00)
Inspectors' comments: i
(Inspectors' Signature - no initials) Date
S. INSPECTION - OTHER:
Passed -I IFailed - [ I Rein ection required ($50.00) . [ ]
Inspectors' comments:
(Inspectors' Signature no initials) Date
DOOR TAGS ARE TO BE FILLED OUT AND LEFT ON SITE IF THE AREA TO BE INSPECTED IS NOT .
ACCESSIBLE AND A RE -INSPECTION OF$50.00 IS TO B CHARGED.
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTRQ,
• (Print or Type)
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b".41'j A o ii Mass.. Oate .
7 kullding LAKation�Q6 6:\5CPermit iso 2_
.�, • .. �����q ice. �.
Owners Name
New ".. Renovation D Replacement irPlans Submitted
FIXTURES
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4THFLOOR
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8TH FLOOR
7TH FLOOR
8TH FLOOR
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(Print or -Type)
Installing Company Name ~�� - - '� '• `•
Address t . 28 CRA J _t li?a _ I'
. A - I.
Check one: Certificate
`Corp.
cPartner.__
Firm/Co.--
Business
irm/Co._
Business Telephone: 6•bn —60913_4� 0
Name of Licensed Plumber or Gas Fitter �NJ/�}s' T
Insurance Coverage: Indicate the type of insurance coverage by checking the
appropriate 'box:
Liability insurance policy �ther* type of indemnity L] Bond
Insurance Waiver: I, the undersigned, have been made aware that the licensee c
this application sloes not have any one of the above three insurance coverages. .
Signature of owner agent of property Owner Agent
i beteby cerdly that alt of the detai4 and Mfotmatioo ! bait wbmitted (or attetsd) iA above applkatWo an tine and soewatt to the best
knowledge and that sY plumbing .rock and inhtAgadose pafotmod under'htmht Imud lot this sprik a" WW be M sonspii.nw with ail Pa
peoeia Q= of the llauachueus 5 ate Gs Oudf sn4 Qtapter lfl of the OWKW LAWS.
-TYPE LICENSE:
Plumber
VGasfittar i9na e 07Lice
aster P1 r Gasfitourneyman
L cense Namoer .
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` Date
202
�—A-Ag.,-...... .
NpRTM TOWN OF NORTH ANDOVER
o� y� p� PERMIT FOR GAS INSTALLATION
ssi9f _a
This certifies that ...........
has permission for gas installation .................
in the buildings of ...?.4 ............
at l.M J. �)� c.s. S � ...S. aL ....... North Andover, Mass.
Fee.2 A,. Lic. No. .. ..........................
02/09/% 12:51 25,00 PAID GAS INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File
n. ry
PER:IiIT NO.
1
APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
PAGE 1
MAP Mn
LOT NO.
I
2 RECORD OF OWNERSHIP DATE
BOOK PAGE
ZONE
SU DIV. LOT NO.
Il—
LOCATION
PURPOSE OF BUILDING
OWNER'S NAME s
NO. OF STORIES SIZE
OWNER'S ADDRESS
BASEMENT OR SLAB.�,L eJ
O.'CJ
ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME
SPAN
DISTANCE TO NEAREST BUILDING
DIMENSIONS OF SILLS
DISTANCE FROM STREET
'" POSTS
DISTANCE FROM LOT LINES — SIDES ; �q REAR /Q ^�'
V
'" �" GIRDERS
AREA OF LOT FRONTAGE!
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTING X
IS BUILDING ADDITION
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION, IF ANY
IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
SEE BOTH SIDES
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE F 7
ED AND AP ROVED BY BUILDING INSPECTOR
DATE FILED /
SIGNATUREiIGNATURE OF OWNER OR AUTHO ED AGENT
F E E ,/4 A..
PERMIT GRANT
19 7d
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST .t it
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOMLATi(i
-6PERMIT NO. /� 61
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
BUILDING INSPECTOR
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