HomeMy WebLinkAboutMiscellaneous - 242 APPLETON STREET 4/30/2018I
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Date .q: 1 .'. � - � -
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that ........
has permission to perform ...............
plumbing in the buildings of .... ........................
at ... ....... , North Andover, Mass.
Fee. .
.... Lic. No .......... ....................
PLUMBING INSPECTOR
Check # '."' 2
5357
MASSACHUSETTS UNIFORM APPLICATION FOR
(Print or Type) PERMIT TO DO PLUMBING
Mass. Date L
u,O, / ,,
-� Permit#
Building Location .2-!92_ .4D(a�p�_ �,,� c�
T-`-`�" --- -`-� Owner's Name
Type of Occupancy
•New
Renovations U' `
r F placemen( ts7�-` Plans Submitted Yes O No Ll
FEATURES
t
Installing Company Name 6_/ AIK �'Yarl yC//3 7"�f3G' �2 i
Address Z, Z (Yf TG'N �TiLc E;
Business Telephone_ 9W, - J_/ -/dvp o
Name of Licensed Plumber_ �s�i9yX Z65/
Check one: Certificate
FJ
❑ Corporation
L) Partnership
l4�jrm/Co.
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142.
Yes 0� No ❑
If you have checked yes, please indicate the type of coverage by checking the appropriate box.
A liability insurance policy a--' Other type of indemnity ❑ Bond D
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:
Si nature of Owner or Owner's A ent Owner ❑ Agent ❑
I 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 installation performed under the permit Issued for this applicatlon will
be in compliance with all pertinent provisions of the MassachusettsWate Plumbino Code and 0haotar 142 of the General Laws.
B
y Signarure of Ucense
Title um .a r
City/Town Type of License: Master L�ourneyman ❑
APPROVED OFFICE USE ONLY) License Number_
4059 Date .... 7121
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that 4 ...... .................... ?
. .
has permission to perform ....... ...............................`...../..........
.. Xr
9Q............
wiring in the building of ... ......................................................
- 6 � 9,- ".-Jp/n/,�# S/ ............... r1Z
at ....... ..... .. h Ando
.... .. ....
Fee../3.'..' ..... Lic. No/��/"Y.f !.... LECrRICAL IN c-roR .. ... .........
Check #
The a)mmonwealr,h of ���a sc:ac)�u _ �` `<`
D epa mn c?u o.( F u b l i c ,,�OJe rt,,
BOARD OF FIRE PftEVtNll7hi AL'GUL"T17NS 5,'27 Chi fl 1: Ca? ]/yp
itc�wc ot.nk)
APPLICATION FOR PEI;MIT TO PERFORM ELECTRICAL WORK
itill .ork to b< p-niorrncd In accaidancc wish tl,c hin +,chu,<n> l lcctrl l Cock, 52? CMR 12;00
FYI ti`E P.R2NT 11A LZ1F. OR TYPE -a--L, 1112Ohl:i�I101-i)
hro.�* <, ;„� Pace
te t. or Loua
of
"aacc.-.sk t: F:' `1.P Ch c�IJ1.S r. W1
ire
The ndersiymed appiie:s`f'or pdna�t c�,p4t.ioru,cho;.ciceeri al Jrh des"cr`lbdo 'txloW.;
Is chis pctzaLc in canjunetion wLch a buildinb yerwic; Yes No (flack Appropriate Box)
Purpase of BuildCng� �T—Liciliry .Authorization 110.
F_:i;cing -crvice Awps % Vales c�cncca<1 Undgrd No, of Mecers
?Icy S.-rvi:e .__-Awps / Volts C�rerh<ad L'nde'' a El No, of Meters
iica=ber of Feeders and Ampaciry
Tac.scion and Nacure Of Proposed E•lccrric-al V101:k
No.,oi Lighting Oucl.pcs
No. of Ilat Tubs
No. of; Transformers T�A1
CeneTacors F.YA
No. If Li htin Flxcures
& &
-
SuLuwing PQal AUovc In' f 1
6rnd. y17 0
Ki., of Receptacle out.lecs
No. of Gil Burners
�._
No. of Ewergency Lighting
BattEry Jnits
t(Q. QS Switch Ourlats:
NO. Of Lias Burners
rlU AL RNS No. of Zones
No. of Drcaccion and
Initiating Devices
No. of Sounding Devices
No. of Self Contained
Detection/Sounding Devices
u
E.aM
CalD Conicipal nnec,cionElOrher
Low vol Cage
Wirin-
Na. QJE RangesNo.
of Air Concl^^ Total
tons
No. of D1SpJSa1S
_
Heat . Tocal Toc1l
No. of pwp 9 Tons Kt4
No, of Dishwashers
Space./Arca Heating YW
tiJ_ of Dryers
No. Or Wacer heaters }::
H'acing Devices K1
NJ Ok �Q. O�
it<nS Ballasts
Ho. Hydro. Massage Tuos
No. of i•Sacors 'Total H -P
IliSURAIiCE OOvzRACE; rursu-anc to the requirewcoci of H4.i sachuseccS Ceneral Laws
I have a current LiapillC Insurance Policy including Completed Operations Coverage or its substantial
equivalent. YES NO [] I have submicced valid proof of same cQ this office. YES ❑ NO (]
If you have checked VES, please indicate the cy-pe of coverage by checking rhe appropriate box.
INSUR-.NCE [a BOND a OTHER EJ (Please specify)-_
Escizaced Value of Electrical Work IS 5-0
Work to Start Illspection (lace Requested;
Signeq -u.-•ler the pznslties of perjur;•;
Fm'i NAME '5L�e7-x' e—
Rough
Expiration ace
Final
LIC.
/ I ,. _
Licensee �V,Si� c.Tt`I�fii�?r'�%c� Slgnatura ( (/'� (�� _ Nt]_ 9
AQare 9a •LJ: ��YdV CLQ !�7a� Bll9. T21. NO. �7-�i "tis;
Alt. Tel, No.
01.WZR'S 1NSUPLkNC.E N/,IYER. I aw aware chat the Licensee doxy nor have cha insurance coverage oc cs eub-
acantial equivalent as required by hiassachuset.ts Cenaral L+ws and chat wy signature on chis permit
application waLvea chis requirement. Owner Agent (plaase check one)
Tc lephone No. FERMIT FEE S
(Signature oe Owner or Agen-c
N2, 3 4" .
.
Date. . 7 1 t
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that i'.. ........ � .................... .............. ........ ............................
has permission to perform ......... ...........
wiring in the building of ......... . .....................................................
r.
... ..... ...
........... "*2^North Andover, Mass?
at ...
Fee... Lic. No./ x ...........
ELECTRICAL INS�EC—T' 0' R**
Check # 17L 8-1 6 Z;�/
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
a
�� �7 Perrot N'o. 3p2 7 /
aparEncenf o�}ire �ervicz� - �
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
�[Rev. 11199) �---
ticavt blank)olan�)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL VVORK
All work to be performed in accordance wills the Massachusctls F-1cctrical COdc (,`,112C), 537 CMR 12.00
(PLEASE P[?I1VT 11V 11VK 012 TYPE ALL 11VF01Z,W, MON) lla tc: 3bo/,o /
City or "Down of: %i, onl-1yt°'v- To the 111spector of f•Y'ires:
By this application the undersigned �,tves notice of his or her intention to perform the electrical work described below.
Location (Street, Number) 02,ole-ba
Owner or Tenant LS M Y/�- TeIephone No._671
Owner's .address
Is this permit ill conjunct; n with -1 building permit? yes No
(Check AppropriateBox)Purpose of I3uildin���
Utility ;\utltorizltiun No.
Existing Service Amps / Volts Ovenceld Llndgrd No. of,lletcrs
New Service Amps / volts overilead L -i Undgrd u \o. of:tiIeters.
Number of Feeders and Anipacity
Location and Nature of Proposed Electrical lvork:
Al
No. of Recessed Fixtures
No. of Ceil.-Susp. (P addle) Falls
,crus ncav ve ucr:cd ov 1Jrc tusccc;or c1 iV(rc•s.
t`+o. oC 10 .1
Transformers KVA j
0. 0f Lighting Outlets
'No. of Hot Tubs
Generators KVA '
i
No. of Lighting Fixtures
a Above I11-
S rimntin� Pool amid. ❑ arnd.
li o. of inerbetlCv tgnLug
Battery units
LNo. of Receptacle Outlets
No. of Oil Burners
i
FIRE ALARI'IS No. of Zones l
I
�No. of Switches
No. of Gas Burners INo- of lletection and
po. of Ranges
Initiatina Devices
No. of Air Cornd. total
Tons (Nu- of Alerting Devices
0. of Waste Disposers
Meat Yuutp Number i ions ! K1`r 1N0.
_.._.._..—I__..-................. ......._.._j
I 1DetectiOtl/AlPrtin(7
oC SeY-Contained
Totals:
T)P.•i— '.
No. of Dishwasllers jSpaccl:lrea Heating KWLocal [� Municipal, -i r
Connection O 1 e:
`+o. of Divers Heating .4ppliauces Svstens:
y VNo'of Devic s or Eg z
I`u ul Water II\o. 0t
Heaters K I Silts i 0. Ot I C: t:r . `;ring:
Ballasts f `'r�. 0f De%iccs
... )` Eijul' :CfiC
I- i,,.clJl;lnillnlCaUOnS
No. H dr ;s,age 1?atL. bs u. of .,i;;iors TOtai lir
v0. Of De•: ices or Equi•: lent
OTHER:
;411aclt CdC: rltOa%.. _<.... .0 2Si n�;:, or as-
ENSUIL-�,INCE COVER --\GE. t,niess Xarre . by the �. ,. no
..
;lance :c:c . ica! •wor'.. n:a• ... _.,...
the [iCCnSec Crovld'-s oloofol ii--biii-v 1iisurallcC IIiCIUd:i; CCn' e� 0^ uA
or :I
S s:.�Sia.^,gal
ltnde:SIa. Cd CertifleS that SIIC11 COvera�e Is In forCC, aiid has exhlbitcd Drool Oe sCC;e to t!;e
CHECK ON'I�S�Z\�:CS I i �O;"iD i 1 0 -['HER ❑ (Specify:)
21 in•� vu♦
Estimated Value of E'.cctrica! Work: (When required b•: :;unicioal polic%.-
Work t0 dart: IItSDcctloiis to be r_alleSiC1 III accordz:iCC'. ., MEC Rule 0, a,!' uUC,1 CJ 1
f curtif', lurdc•r the f7a111s altd penal(ics u�rpel7ur-,•, the,, the ilrlurmation On tris ap Qlicatiult is true 71111 caltrple te.
r1IL�l 1E �r; r1�-s rn� . u r LIQ �\o.: ( —
Licensee: �G1r�� CrtL�\{.�l SignatoiMA
�'S
LIC. `i 0.: CC�i
ll�di:nirc (z, enlcr' _a :,r1;r i,r 1ltc iiCClr.c2 arinrC�r iirrC.) -0 j . / 7 ),4 i,'
mol I3u5. TCI. �O.:"t I �J� t\ddress: �5� �JL'�� Sii�jt tl�rn,(tc� l�Alt.Tel. No.:q�2-14.23-1-i�l5G
ON NER'S INSUR-ANCE \':.GIVER: f ant aware tli the Lic,-ttsee does,rct.'cl'2 the liability insurance covera,e ::ormallv
required jv [: w. E�.:nr SI,!;atllre below, I hereby yai', e this requirement. I zip iht (check onc) ❑ o.-ner ❑ o ;.c' s
Owncr/Agent
Si;nature To!cphoI,,c No. l PI:R:1fIT FL£•.: S 35