HomeMy WebLinkAboutMiscellaneous - 253 HICKORY HILL ROAD 4/30/2018 (2)I�•
w' Office Use Onty
K T u�IE LIIITITIZIIIt1UEt��ti1 of �fic�L lI E Permit No.
+fie IIIZtBIPIII DfLtbitt s-IIfEtq Occupanel 8r Fee Checked
r� 3190 (leave blank)
BOARD OF FIRE PREVENTION REGUUTIQNS 527 VP 12:00
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12: 0
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Oate
a);j or Town of NO M ANDOVER To the Inspector of wires:
The udersigned a^^I;-� fns a nPrmit to oerform the electrical work described below.
Location (Street g
Owner or Tenant 4/17/
pwr,er's Address
Is this permit in conjunction with a building permit: Yes — No (Check Appropriate Sax)
Purccse of 9uildina Utility Authorization No.
0 Amos �.G1�Vclts Overhead '— Unegrnd No. of Meters
Existing Ser�ice2—
Ne'.v Service Amos —J Vcits Overhead - Uncgrnc _ No. at Meters
Numeer of Feeders and Amcac;ty
Location anc Nature of Proposed Eiectnc-ai .'IcrK
_
Totac
I No. of Transformers KVA
No. at Ligr.cing Outlets I
No. at ...., .VVs
No. at Lightng Fixtures Dom/ i
Above— In-
Swimming ??oi grnc. _ crnc.
-- I KVA
_ ! Generators
No. of Emergency Lighting
No. of=ecectacie Outlets
No. at Cil Burners
Battery Units
I IRE ALARMS No. of zones
No of SNuch Outlets
No. or Gas Surr,ers
total
No. at ^etection and
No. of Ranges
Nc. ct Air Cor.c. tens
Initiating Devices _
`
Noor HH eat Total iotai
:ons Kw
No. at Sounding Devices
No. of Disposals
has
No. of Seif Contained
i
Kb'J
oetec:.ontSouncing Oev ces
No. of Oisnwasners .-
ScaceiArea r!eating
-
Heat:fsa 'Oev:ces `w
— Mun c:oai -- Other
Local Connec:;on _
No. of Driers
No. of No. at
I Law Voltage _
No. of water Heaters KW I
Signs Ballasts
winnc
No. :-+yarn Massage Tubs
No. of Mctcrs Tacai FSP
�^
1���
P
OTHER: J
/'2
INSURANCE COVERAGE. Pursuant :o the recuirements ct .'.fassad'csatts general Laws -
I have a current Liaor,ity Insurance Policy inducmgcC mc:etelCOceran` ;suv^ave c.^ecxec YESor Its S aeasential ?naicateeehe type cave ge Cy
have suamirea valid proof at same to the Office. 3y C
cnec Xing the aopf riate COX. /
INSURANCE 1BONo = OT} -!ER = (P!!eaa�se Steely) (Exocr lion Oatei
Esumatec Value of E!ectrtcai 'Norx 5 LCSV Finai
Inscectton oata Racues:ec: Rougn
wcrx :o Start ]
Signea unser :he Penalties t erlury„ ,! /N LIC. NO. —v S�2
=inVt NAME �D "C. NO.
Licensee Sig^acute -r .,_2
/ /� o Sus. Tai. No.
Address
�U // // v rlci ��% r' Gam` ' �fC� AIt. :el. ^to.
OWNER -S INSURANCE ,vAIVER: I am aware that tn.e ! :censee does noc nave the insurance coverage or its suostanual ecuivaea as
euirea ov Massachusetts General Laws. ano tnat my s:cnature an :n:s Cermit aOpllcatlon waives this reauirement. C'wn (�
(P!ease cnecx ones r
'aecncne Na. PERMIT FEE
(Siarature at Owner or Agent
a'"�s�"+y'.1'v'�„"'.-�r.�...e-.:,4yx.�v;'Wx.--...��-n..r'�:y: •s-�_..; -ic.-'�;+�.Ci"�f^".''�9..:;/y:''yF.'s:�
Date...�q .C./....
No 7$9
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
S
This certifies that ...... .o . ..... .... .......... ...:....
has permission to perform .......1.4.5 2..4:k!.�t^..... t,J4l.t..4'�.
wiring in the building of ........ re:.� t (kl1 l
.:°...... .... . v......�................�
o+
at 1 .. , t 1+x,,2 �.....:....�............................ . North Andover, Mass
Fee... L.. .!... Lic. No.l�r. So�,%.............. ..............................................
T I - ELECTRICAL INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ,
310 CMR .10.99 _ .
Form 8 'DEP File Na, 242—_47A_____1'
,. no be utov,oed by DEP)
C,(, lows Nortli Andover
_ Commonwealth
-if of Massachusetts Avoucanr George R. Barker Jr. -
2 3 4 9,10,11,15,16,17,
(Lots 1, , ,
Fl 18,19,20,21,22,23,24,25, 26 & 27)
'`-_`• Hickory Hill — Barker Street
Partial Certificate Of Compliance
Massachusetts Wetlands Protection Act, G.L. c. 131, §40
NORTH ANDOVER CONSERVATION COWIISSION 'Issuing Authority. •
From
1267 Osgood Street,
North Andover, MA 01845
To George R. Barker Jr.,
(Address)
(Name)
Date of Issuance Aril 18 1991
This Certificate is issued for work regulated by an Order of Conditions issued to George R. Barker Jr_,
T Oct. 4, 1988 NACC
dated and issued by the
1 •
.1) "It is hereby certified that the work regulated by the above -referenced Order of Conditions has
been satisfactorily completed.
Z• j�k I1 is .hereby certified that only the following portions of the work regulated by theabo�e•reler-
enced Order of Conditions have been satisfactorily completed: (If the Certificate of Compliance
does not include the entire project, specify what portions are included.)
Applies .to the above Lots .ONLY......
referenced Order of Conditions was
3• L_It is hereby certified that the work regulated by the above
never commenced. The Order of Conditions has lapsed and is therefore no longer valid. tJo future
work subject to regulation under the Act may be commenced without filing a nev: I;ol�ce o1 Intern
and receiving a new Order of Conditions.
................................................................. ...
(Leave Soace Blank)