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10299
Date .....� .... ... ..
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that v ...........................
has permission to perform..................................................y.........�.s�...,
wiring in the building of ..... 7 t.. .......... !!o .9.........5 .........................
at ...... ....... /%I:...1..... ...... � !' .. .................... . NYONSPECTOR
Ando a Mass.
Fee... :.. LIc. No. �. G . ... ...... .........�-..... .................
ELECTRIC
Check Jt,3�%j�b3'y '/
2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance -with the provisions of M.G.L. c. 143, § 3L, the ;
permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed
on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an
electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the
notification of completion of the work as required in M.G.L. c. 143, § 3L.
Permits shall -be limited as to the time of ongoing construction activity, and maybe -deemed -by the7nspector_of _Wires abandoned-and-invalid.ifhe—_- .. _
or she has determined that the authorized work has not commenced or has not progressed during the 1reoedifig f2 -month period. Upon written
application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written
request of either the owner or the installing entity Mated On the permit application.
The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of
the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this
purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property, With
limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was
"in effect or existence" during the qualifying period beginning on August 15, 2008 and extending"through August 15, 2012.
Rule 8 — Permit/Date Closed:. Z—A /2�� * Dote: Reapply for new permit
❑ Permit Extension Act — Permit/Date Closed:
M
L_ommoruvea& ,, If/a3aacImirtij Offic:'sal Use Only _- ------I
`' W c� c�77 Permit No.
T
..L.leparC•n•.,ena� o�._Y'ire �ervksd
Occupancy and Fee Checked
BOARD OF FIRE PRFVENTION REGULATIONS �[Rev. 1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the iri�ssachusetts Electrical Code (MEC), 521 CZl/
R 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFO 1,V ION) Date:__
City or Town of: _� �_ To the Inspector o Wires:
By this application the undersigned gives notice o�s� r her intion t perform the electrical work described below.
Location Street & Number cX . l
Owner or Tenant —�� yj' i�L `UK ( LPL
Owner's Address _.7-1
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
Location and Nature of Proposed Electrical Work:
Telephone No. - r\3 103�
Yes ❑ No Z[, (Check Appropriate Box)
Utility Authorization No.
Ove-rhead ❑ Undgrd ❑ No. of Meters
Overhead LJ Undgrd U No. of Meters
Complefioi: of the following table may be waived by the Inspector of Wires.
No. of Recessed Luminaires
No. of Ceil: Susp. (Paddle) Fans
No. of Total
Transformers KVA _
No. of Luminaire Outlets
No. of Hot Tubs
Generators KVA
No. of Luminaires
Swimming Pool Above ❑ Ln- El
rnd. rnd.
o Emergency Lighting
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
o. of etethon and
No. of Switches
No. of Gas Burners
Initiating Devices _
No. of Ranges. .
g
No. of Air Cond. Total
Tons
No. of Alerting Devices
No. of Waste Disposers
p
Heat Pump
Totals:
Number Tons _
KW
o, of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
_
Local ❑ Municipal ❑ Other—
Cyyonnection
No. of Dryers
_ _
Heating Appliances KW.
SecNo of Devices or Equivalent
No. of Watero.
KW
of No. of
Data Wiring:
Heaters
Signs Ballasts
No. of Devices or Equivalent
No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring:
� _ No. of Devices or Equivalent
. --- --
OTHER: � � goZ�--- --- �
Attacb additional delcil if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: _�=_ (When required by municipal policy.)
Work to Start: 04 Inspeciions 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 119 BOND ❑ OTHER [] (Specify:)
1 certify, under the pains and penalties ofperjury, that the information. on this application is true and complete.
FIRM NAME: -- u ntl Ai^_ ��Ges' _ LIC. NO.:
—J----
Licensee: 2—Y1 n W Ofd Sigrtat.,trc: ,.,_ ----� _ ._ ___ __ LIC. NO.: �:q6
(If applicable, enter "exempt " in�e license number to V Bus. Tel, No. -I
Address: _ L � L r� � 1t ��", A-211- 109 4(19 Alt, Tel. No.:
*Per M.G.L. c. 147, s. 57-61, security work requires Deparraient of Public Safety "S" License: Lic. No. Ss C / 73
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hove the liability insurance coverage normally
required by law. By my signature below, I hereby waive this t equireu,ent. 1' ain the (check one) ❑ owner ❑ owner's agent.
Owner/Agent
F'ER1b1IT FSE: $
Signature Telephone l"' -.o._ ____—._---
COMMONWEALTH OF MASSACHUSE.
e . e
OF ELECTRICIANS
REGISTERED SgYoSETEM s LICENSE
i
KENNY Q WONG
22 FIELDSTONE DRIVE
BURLINGTON MA 01803-4213:
i 07/31/13 814647
5966 D
)PS-CA1 i, 40M-08/08-()BSLIFOR,ACA108212008
177
s//ce U� omvrnonwea.�iiz PUBLIC OF UBLIC SAFET`(
Certificate of Clearance
Number: SS CC 001975
Expires: 10/09/2011 Tr. no: 558.0
S -License: ADT SECURITY
KENNY WONG
IS CLINTON DR
HOLLIS, NH 03049
t
Date .... �.?.
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that .......................... ..... .........
has permission to perform ..... ...... ...........................
wiring in the building of ...........
j wz-
............ .......................................................
at .... Z ------- .............................. . North Ando er, Mase.
Fee Y.7 ............ Lic. No.c. 31I� ... ...
Z. 1 -G. ......
LECTRICAL ZR
Check
-161. I - ...
2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance -with the provisions of M.G.L, c. 143, § 3L, the
permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed i
on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an
electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the
notification of completion of the work as required in M.G.L. c. 143, § 3L.
Permits shall -be limited as to the time of.ongoing construction activity, and may be_deemed_by-the.lnspector_ofWires abandoned_and_invalid.ifhe—_ .. _
or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-ruon4h period. Upon written
application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written
request of either the owner or.Mstalling entity stated on the permit application.
❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of
the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this
purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With
limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any pemut or approval that was
"in effect or existence" during the qualifying period beginning on August 15, 2008 and extending through August 15, 2012.
,ICRule 8 — Permit/Date Closed:.Z Z ***Note: Reapply for new permits 1
❑ Permit Extension Act — Permit/Date Closed: �" �
Q
..
ii
L1nu'n0nC(1eA[4 o/ Wla66ackvade
a ffi-
epar o Jcre �ervlce6
BOARD OF FIRE PREVENTION REGULATIONS
Official Use Only
Permit No.
Occupancy and Fee Checked
[Rev. 1/071 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORD
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORIu1AT10N) Date: - �P/a&ILl
City or 'own of: A. . �d-OV � To the Inspector of Wires:
3y this application the undersigned gives notice of h,i�ssqr her intention to perforin the electrical work described below.
Vocation (Street & Number)_o2 t "(L C-'ee.,?6L
Owner *or Tenant - S Telephone No. 3
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No M (Check Appropriate Box)
Purpose of Building
Existing Service Amps / Volts
New Service Amps ! Volts
Number of Feeders and Ampacity
Utility Authorization No.
Overhead ❑ Undgrd ❑ No. of Meters
Overhead ❑ 'Undgrd ❑ No. of Meters
Vocation and Nature of Proposed Electrical Work:�� l`�� B, J ��C,t,�t �V 1 • .'�t�r�; �rrn
Com lelion of the following table may be waived bathe I,nsnector of Wires
No, of Recessed Luminaires
No. of Cell.-Susp. (Paddle) Fans
I'vs Tonal
Trr ansformers Ki A
No. of Luminaire Outlets
No. of Hot Tubs
Generators KVA.
No. of Luminaires
SWimmiizg Pool Above ❑ In-
rnd. 2rnd.
N 0"— Emergency Lig . ing
tte
Bary Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. ofwitches
No. of Gas Burners
No. of Detection and
Initiating Devices
No. of Ranges
No.. of Air Cond. Total
Tons
No. of Alerting Devices
No. of Waste Disposers
Heat Pum P
Totals:
Number_
......
Tons..........
KiiV
' ""'.
_
No, of Self -Contained
Detection/Meriting Devices_ `5�
No. of Dishwashers
S ace/Area Heating KW
P �Loca1❑,Connection
milcipal
Other
No. of Dryers
Heating Appliances KW
SecuritySystems:*. No. t'Devices or Equivalent
No, of Water KW
Heaters
No. of No. of
Signs Ballasts
Data Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
_ilNo.
No. of Motors Total HP
Telecommunications Wiring:
of Devices or Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires,
Estimated Value of Electrical Work: _ (�(Q� (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 [N BOND ❑ OTHER ❑ (Specify:)
1 certify, under the pains and penalties ofperjury,_that the information. on this application is true and complete.
FIRM NAME:I;IC. NO.:
�
L WSJ
,icensee: rc-) CL f Y,, � (`` � Signator � LIC. N(�.:
(Ij"applicable, enter "exem t " in the license nu;nber et r (o p," �ld'�,
Address: _ G� n d� t•, ' ,`�, O3U Bus. eI. No.:
Alt. Tel. 1V'o.:
`Per. M.G.L. c. 147, s. 57-61, se�"
security work requires Department of Public Safety "S" License: Lic. No, Do 3
OWNER'S INSURANCE WAIVER:. I am aware that the Licensee does not have the liability insurance coverage normally
required by lave. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner C] owner's agent.
Owner/Agent-
Signature — Telephone No. T FE, E: w —
=AP�EGISTERED SYSTEM CONT �ACTOP..=
= •:' ISSUESTHEABOVELICENSE Tb:
:'•' _
E'-CURaT-Y, SER'VICE_S•, :.ING :i;=:..:•
F:,.hiAPK-.A :BROPHY:._SR :
iUNIVERSITY.-AVE
:-:.FESTkiQOD M.A:.02.09.0 231.7.:':,:=....
C 07/31/13 ;849174�'.�'.
1- Fob• lion DO= Alonp.Ah P2eomdo
Keep top for receipt and change of addre
DPS-CA1 c, 251d-1=9-10162009LICEKSEFORMI
f�.e 'Ena�:.r�anmu�cal�• ��✓I .k:r/.C/lC4:P.�tf
2\- DEPARTMENT OF PUBLIC SAFETY
S :License
agl!Number' SS CO 000953
Expire' :-02/07/2013 Tr. no: 195.0
S -License: ADT .
MARKA BROPHY•SR .
410UNIVERSITY AVE G� �1'
WES WOOD, MA 02090 DIG SAFE•CALL CENTER: '($88) 344-7233 •
Commissioner
.... No 3 1 17
Date....f
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
�..
d PThis certifies that....................t..'......//o .................
....�..'.
.....
has permission to perform ........ ..........
wiring in the building of�2 ,l
/1
%' . �.. ��... ? � ,s!', North AndoveriMass.
at.......... ....i;. ............
Fee.. >.,
............ Lic. No. ) . _ f ....
ELECTRICALINSPECTOR
Check # X
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
e
�z arfncertE o�Jira ��ac�ttcde:G gag — OGici;rl Usc Only
Pc,rrji No.
BOARD OF FIR` PREVENTION REGULATIONS Gccuoancv and Fee Chec`ed
(lc�ve blain:)
I
APPLICATION FOR PEMAIT TO PERFORM ELECTRIC
All tvurin a
< to be performed iccordcutce with the 'vtasszchusctts Clcctric:il CodAL WORK
Code (,.,IEC), X37 C\(R L
(PLEASE P1UNT GV 1!VK OR Tv.00
.) r 1LL rVt-0RM, I I70N' llatc:� l O
City or -I•own of:�/�O� To flee Inspector o tL �—
By this application die undersigned _Ives notice of hes or her intention to perform the electrical k described below.
Location (Street �C 1\ur�{ber) p� d
Owner or Tenant , er,
Owner's address
Telephone No
Is this permit Ill coll)unC n with a buildir b permit.' Yes j
`• } No (Ghee!:.\pprnpriatc I3oz)
I'ucposc of I3uildina r(,� / UtiiitN Authorization No-
Esistin" Servicet\nips / Volts Overhead El Undgrd
\'u. of IlIctcrs
New Service Amps/ Polls ON'CrilCad C Undard
o No, of 1letcrs.
Number of Feeders arid Anlpacity -
Location and Nature of Proposed Electrical Work:
Comoie!(on U(ilr2 'Clrut rr ! ^/
_-
No. of Recessed Fixtures
lNo. Ced.-Susp.
, ,cr„ . „un• oc ucrrcd o�•!!rc lrrs[;cc;oro�i!'ire;.
01
of (Paddle) FansIy0.
Doral
l•fransfornlcrs
No. of Lighting Outlets
No. Iluf Tubs
KV':\
of
f Slrinlnriny Pool r�0� e C atl"
Generators K'VA
170.0 meraericy r;trtrug
(Batten-
\o. of Lialltlll� Fixtures
_rnd.
IND. of Oil Burners
INo- of Gas Burners
Units
FIRE ALARNIS l\o. of Zones
lr\o- of Detection and i
No. of Receptacle Outlets
No. of Switches
Initiating Devices +
NN U. of Ranoes
�-
Total
Tota,
No. of air Cond. Tons
lNu• of Alerting Devices I
:\o. oC�Vaste Disposers
Hent Pump ' Number' (•ons ! I -,v
I_.._._._r__.._................----......._._
No- oCSelf-Contained
I
,
{
lDetectioidAlertinz Devices
�No. of Dishwashers ISpacc/Area
Heatinu KWLocal
----
I'lunicipa!
i Connection 1 LJ O he, 1
�`(o. of Driers
! -
Hentina Appliances ICS`
�e tv Svste; s:
•
-Deices
WaterNo.
�I\o. nC No.
of or Equi••c!e!i,
I -(eaters Iii"v I
of
Balla
Sins sts
I r,
"'`tri r;no:
itio. Htdr :r,assa,,e Isat!!tubs
. otaiF
I \"0. of Jo ccs ,)r Lc u ; aienr
-----
il:etunlunicatios rir;S:
/1-rc7r. n.
No. of Deviccs orEqui; a[e,
I i!k:Ch oddi!io!ta: ___... es;r,r
\'SUR-\.iCE COVER_ -\GE d - or- rCC
Un •.val�.e by the .. � �
c.,,,_ no ., ....:t nance J,
t(le licensee crovid�s prccfofii::bi.• t ---- �. c:�c..icai wor:. e,..; ss.I�
t nsurancc !nc.udin; ' con:D: cove-:IZT nr ts'su;:stcnt,al e `
UI:GtCrS1?nC^ certiRies that Sl;cl1 covlerag'_ Is Ill force, atid has eYlllolred Proof of Sa':e t0 ll:e ^•Cr;'i11t
CHECK ONE: INSL'L.\NCE EO;N:D i i 0-1'HER ❑ (Sn:)
ecif;
Lsticnated Value of.Elccti Vor :
(`rVllen required colic;.)
wof-k to Star. Insocctions to be requested ordancc MEC !e
r. ace R 0, aI:C uuon ccr ple::c . .
1 cer!rf •, 1111110' the/nri!rS (711d 17c�rral!ics U'rgerjr1g, thn't lire information o!r :iris alrnlicatiorr is� lace a!ld cormle!e.
\':\SIE: a ,-
IJC L, r •{-�
Licensee: CV -y) C f t; h 1 -Ci l Sisuatur' LIC. NO.: OG 11 l
(r`vi;piic',:�ir. erucr ;.'rrr!;! " irr !ire iieen<< rrruuc�r lirrc.) Tel. t\o.:`"�t-],� - �+57 -O`•iy,j
�� n Ill � 1 s Bus:
:\ddress: t55 y�P � Si StC.. - � Alt- Tel. No.: � lY- q_; �-yl:��t
O\� NER'S I;` SU[::\:\CE 1;:�iVEI2: ant aware that the •Licensee docs ncc:. ,,; the iiuji1ity insurance COt e:a',e ::or :llai!v
rC^,uirc6 by t: w. 13%- ::1,, S `!la(LIrC be!ow, l hc;-,-b ' tills re"1u:rc!Tlc:;(. ! r:A :11d(CI;CC:<
motic) owner O�t'::C,` S c - :;t.
Owlicr/.Ait -
Slarlatul'e
['cicphor,c \'u. Pi;R:IfIT f LE: S �