HomeMy WebLinkAboutMiscellaneous - 207 FRENCH FARM ROAD 4/30/2018RIO
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4199 Date ...... 4 - ?0 fi�-
0 TOWN OF NORTH ANDOVER
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#-p PERMIT FOR WIRING
SACHU
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This certifies that ........7.... �?c ....... ��.st .........................
has permission to perform ........ 5-ec .. /s.xt ........
wiring in the building of ...... KC .!�15 ....................................................
at ....r--.�`!!4 .. North v�qs.
33(
.................
Fee.. A")... Lic. No. 0 ....... . ........... . .... I ...................
Check #
Commonwealth of Massachusetts Official Use Only
Department of Fire Services Permit No.
� ��
BOARD OF FIRE PREVENTION REGULATIONS 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 (MEC), 527 C R 12.00
(PLEASE PRINT IN INK OR TYff ALIS INF RMATION) Date:
j1110160
City or Town of: To the Inspector of Wires:
By this application the undersigned gives not}'se of his or her intention to peAofrrt the electrical work described below.
Location (Street &
Owner or Tenant
Owner's Address
Is this permit in conjunction with a building permit?
Purpose of Building
Existing Service Amps / Volts
New Service Amps / Volts
Number of Feeders and Ampacity
Telephone N
Yes ❑ No g (Check Appropriate Box)
Utility Authorization No.
Overhead ❑ Undgrd ❑
Overhead ❑ Undgrd ❑
No. of Meters
No. of Meters
Location and Nature of Proposed Electrical Work: Installation of Security system
Completion of the following table may be waived by the Insnector nf Wiree
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-
rnd. rnd. ❑
o. o Emergency iging
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
o. of Detection and
Initiatin Devices
No. of Ranges
No. of Air Cond. Total Tons
No. of Alerting Devices
No. of Waste Disposers
Heat Pump
Totals:
Number
Tons
KW
No. of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Municipal ❑ Other
Connection
No. of Dryers
Heating Appliances
g pp Kms'
Security Systems:
No. of Devices or E uivalent
No. of Water KW
Heaters
o. of No. of
I Signs Ballasts
Data Wiring:
I No. of Devices or E uivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications Wiring:No. of Devices or Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
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:)
(Expiration Date)
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.
I certify, under th pai rs andpenalties ofperjury, that the information on this application is true and complete.
FIRM NAME:S=4icas LIC. NO.:
Licensee: John S. Bassett Signature LIC. NO.: 1533C
(If applicable, enter "exempt" in the license number line.) Bus. Tel. No.• 603 9Sq
$
Address Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Li see does not have the liability insurance coverage normally
required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $
0
1
O The Commonwealth of Massachusetts Office U9e Only J
Department of Pubtic Safety Pertmt No.
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy A Fee chw-•: �
` 3190 pea" blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOR
M wont to be pwoun"ed be &00*R = wtte dna Mas.acnusans E10ea+eat Coes. $V CNA t2o0
(PLEASE PRINT INi INK OR TYPE ALL INFORMATION Dated f.S�
City or Town 0 o L/ ell -
-The undersigned applies for a permit to perform the electrical work described below. To the Inspector of Wires:
Location (Street S Number 0 != K' e ce 1�
Owner or Tenant I -Oct
Owner's Address- JZ A till V -7 -
Is this Permit in conjunction with a building permit
yes ❑ no ��- —� (Chr•,k Appropriate Box)
Purpose of Building— Utility Authorization No.___
Existing Service amps r Volts Overhead ❑ Undgrd ❑ No. of Mete
rs—
New Service Amps t Volts Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nar"e of Proposed Electrical Work_ W r f2 t= %!m*`- '� c4Te S'jp /•Q c '� `y fc
of
No. of
No. at
No. of
No. of
No. of
No. of
No.
No. of Hydra Massae Tubs
OTHER:
No. of Hot Tubs
Above
Swimming Pool grnd.
No. of Oil Burners
No. of Gas Burners
No. of Air Conditioners
of
KVA
KVA
FIRE ALARMS No. of Zones
'AL No. of Detection and ~'-
4S Initiating Devices
'OTAL No. of Sounding Oevices
KW No. of Sett Contained
KIM ( DetectionlSounding Devices
Heating Devices KIN
No. of No. of
Signs Ballasts
No. of Motors Total HP
Municipal '—'—
Connection ❑Other
r
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current Liability Insurance Policy inclLuntg dCompleted Operations Coverage or its substantial equivalent. YES p�iCC�Q i heave submitted
vattd proof of same to this office. YES &Wo- O
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE 2 -A$OND ❑ OTHER ❑
(Please Speciry)
(Expiration Oats)
Estimated Value of Electrical Work 3
Work to Start / -� - Inspection
Date Requested: Rough
Signed under the penalties of perjury:
Final
FIRM NAM O �� - L L �CTd r�C
UC. NO
Licensee i"� f = G ori, ®v l U ( Signature -
-09-416W
Address I �t c4 O -e �10A A- <D b'3
LIC. NO.,c,
Bus. 01?
tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its
Massachusetts General Laws. and that my :signature on this application waives this
Alt. Tei.
Substantial No.
equivalent as r8qulr8d by
requirement. Owner
A ent
9 (Please check one)
-
(Signatu of Owner er annnn —Telephone Na
CJ
ATO 2692
0
0
CHU
Date .....1.. l f /171a....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
2
This certifies that ........ z ...........
.....................
has permission to perform ..... ...... 7,7;: /(
wiring in the building of .... Q * 1wi: wto/./ ............................
at ....... -)--6--7 ...... .... f'�!t fl.t .................. . North Andover, Mass.
.......ICA.................
Fee.. �D ... Lic. No./`/`*)�"(./....................
EcrR L . INSPECTOR. .................
L 4 ,
`T,)%
11/09/95 13:28 15.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File
0
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT T0. DO PLUMBIN9
(Print or Type)
Afiodo -e-i , Mass. Date 2 i 19 7S_ Permit#J2
Building Location 6iQ7 flWG-A &6Lh U Owner's Name S o -s L R•t�I+A,%E 79_
Type of Occupancy
New ❑ Renovation ❑ Replacement IIS Plans Submitted Yes ❑ No ❑
FEATURES
Installing Company Name Check one:
Address r 5
O'Corporation
AJC e ' /yl �:� ❑ Partnership
Business Telephone 03LI3
❑ Firm/Co.
Name of Licensed Plumber�D11� j� >� f`U.l S5 s A t.L V
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requiremi
Yes e No ❑
If you have checked yes, please Indicate the type of coverage by checking the appropriate box.
A liability insurance policy 0 • Other type of indemnity ❑ Bond ❑
Certificate
.7�qj3
MGL Ch 142.
OWNERS 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:
5lanature of Owner or Owner's Aaent Owner ❑ Agent ❑
I hereby certify that all of the details and Information 1 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 the permit issued for this application will
be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By
OCT 2 3 ��gnature or icense um er
Tate
CitylTown Type of License: Master Journeyman O
t
License. Number__
APPROVED OFFICF I19F nNI Y)
x
BASEMENT
Poll
■o������������e�MEMO
MENEM
NONE
Installing Company Name Check one:
Address r 5
O'Corporation
AJC e ' /yl �:� ❑ Partnership
Business Telephone 03LI3
❑ Firm/Co.
Name of Licensed Plumber�D11� j� >� f`U.l S5 s A t.L V
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requiremi
Yes e No ❑
If you have checked yes, please Indicate the type of coverage by checking the appropriate box.
A liability insurance policy 0 • Other type of indemnity ❑ Bond ❑
Certificate
.7�qj3
MGL Ch 142.
OWNERS 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:
5lanature of Owner or Owner's Aaent Owner ❑ Agent ❑
I hereby certify that all of the details and Information 1 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 the permit issued for this application will
be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By
OCT 2 3 ��gnature or icense um er
Tate
CitylTown Type of License: Master Journeyman O
t
License. Number__
APPROVED OFFICF I19F nNI Y)
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` Date/v�
No 2664
NOR711
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
�_ •:
,SSACHUS�
This certifies that . /Q/a� �� �.... !..!t. �.............. .
has permission to perform .... Ra14.r,I .. o1AK. G
plumbing in the buildings of Clwaze.S. `fov.nJrAh►�bh .4... .
at.. a.D..7...F/Zi A?r, ,.. FAI?.4........ t4orth An jd v�I�Jass.
.,'' •
Fee. Art. t. .... Lic. No.. 5.491 . ..........
PLUMBING INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File
TkT! 26164
Date/. v���'.�.
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that . X.Z. .4 /a.... °� . � ................. .
has permission to perform ....13V /.' I.C. 12 .. i /p. e .............
plumbing in the buildings of C -14,61e. S .. 10.w A If A. t;" O.'14.1 ....
at. . o?.D 7...F.lZelvc L , F..Ct����-r. ... , North Andover, Mass.
Lic. No.. � �l .R . ....
PLUMBING INSPECTOR
10/30/95 14:44 25.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File