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Home My WebLink AboutMiscellaneous - 273 MAIN STREET 4/30/2018 (2)w 3 b Z� 1 �. iooll f i IL Date .... —.. b .... . ..... .... .... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........... ............ has permission to perform .... X�--2 ........ .......... wiring in the building of . .................................................. at ... ;7::�? ... ..... ;�r .......................... �North Andovei, Mass. Fee .... !;�.574, Lic. No. a. -7 ........ ... ... ... ... v Check # I 7K Y CD CIQ 0 a Q J—= 8h aq 0 'COD t-3 C. CCDI .8 CD C, 0 L4 &D 0 0 1--1 C, -M! C, '0 C, 0 F� ff. ID P CD 0 co, tq. 0 CD ". 9� C' 9 - Ocl Ln tm.2 R r- 0 F t+ r:3* W, R rrM E co, 0 0 lb o 10, cl� "I 4 cp Q), .3 to 441r, CD C, CD C, CD c' " :Z E� t -j d cp a 100 C, P, r4 00 CD 0 4 i':,, Sal 1c, C, li 0, CD b.3 C.D to 5. C, C'D P jL P4 a elmmonw,,& ol Ma.Maclwdh Official Use Only 2epadment ol -7h. Permit No. 106 Ji Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ERev.11071 Qeaeblan� APPLICATION FOR PERMIT TO PERFORM ELECTRICALVORK All work to be performed in accordance with the Massachusetts Electrical Code (mEC), 527 CNm 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: -3 Md I I I City or Town of. kvef— To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. `03 /tAcl;-A E -h Location (Street & Number) 0 - Owner or Tenant Owner's Address 01 Telephone No. Is this permit in conjunction with a building permit? Yes [:] No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps volts Overhead Undgrd No. of Meters New Service Amps Volts Overhead Undgrd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: i.A ; -klla-kor- 0 KW-5vt;;�-aor .-id 6UJ O."t ft 4'*c �rc--%4AV sw�kLl - CO lefign nfthp fnIl—i— -10, —, -- -.r No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans UJ No. of MY' Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above El In- Ei Swimming Pool grnd. und. No. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS7No. of Zones No. of Switches No. of Gas Burners of Detection and Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: F-!! tloiis .... ...... .. I.KW .......... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local E] Municipal Connection El Other No. of Dryers No. of Water Heaters KW Heating Appliances KW No. of No. of Signs Ballasts I Security S stem -s: - D No. of 9evices or Equivalent ata Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wirm No. of Devices or EquivaTent OTHER: Attach additional detail Y -desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start:AP(it' -*101t 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 [I BONDE] OTHER. E] (Specify:) I certift, under the pains andpenalftes o perjury, that the information on this application is true and complete I Po W r �10 Ser in � C FIRM NAME: - - C; LIC. NO.: Licensee: A4rew fiqce- Signature LIC. NO.: 10cOM K (If applicab1,eenter " empt " in ihe license number line.) , Address: OC)C)6_ 5&J0A?-Je A)H d7Y14(o Bus. Tel. No4�5:�- 933Y Aft. Tel. No.60013 ) 015-1; -q17L. *Per M.G.L. c. 147, s. 57-61, security work require's Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check F Owner/Agent �one, —1 owner El owner's agent. P J Signature Telephone No. PERMIT FEE: $ 41 Date. .//IP/W ......... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that has permission for gas installation ... ............... in the buildings of' 4j((.�o ........................ at . .......... S .............. North Andover, Mass. Fee.3P., PP. Lic. No.. ..... GASINSPECrOR Check# 29 V � �— MASSACHUSErIS UNIFORMAPPUCATONFORPERNWTO DO GAS Frl-J�ING (Type, or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations 4P Owner's Name Ne Renovation Replacement rl Permit # Amount $ Plans Submitted (Print or Name — Address Name of Licensed Plumber or Gas Fitter hiecone: Certificate Installing Company Corp: 7' Partner. Firm/Co. INSURANCE COVERAGE Ch0sk opC I have a current liability Insurance policy or it's substantial equivalent. Yes Vq No A --JS., El If you have checked Ms, Please/ndicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 0 Bond 0 Owner's 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: Signature of Owner or Owner's Agent Owner [D Agent 0 I hereby certify that. all of the cletalis ana injormation 1 nave SumillUrlu kul caltvjru) 1ji auv— aFF—L—A —AU --Lat� LV LJJQ best of my knowledge and that all plumbing work and'i'ostallations performed unoer Permit Issued for this application will be in compliance with all pertinent provisions of the ssachu)etts ?1e Gas Cod7/� Chapter 142 of the General Laws. 1�d - In - Y: �tle I C i t y/Tjw—n OVED (OFFICE USE ONLY) Sianature of Liceng'e�umber Or Gas Fitter Plumber Z4,00 Gas Fitter License Number Master Joumeyman !B A S TM -E N T 11 T. FLO1111 R 2ND.FLOOR 3RD. FLI 0 0 R '4TH.- FLOOR 5TH. FLOOR 6TH. FLOOR �j�T�H � TL 0 -OR :STH. F L 0 0 R (Print or Name — Address Name of Licensed Plumber or Gas Fitter hiecone: Certificate Installing Company Corp: 7' Partner. Firm/Co. INSURANCE COVERAGE Ch0sk opC I have a current liability Insurance policy or it's substantial equivalent. Yes Vq No A --JS., El If you have checked Ms, Please/ndicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 0 Bond 0 Owner's 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: Signature of Owner or Owner's Agent Owner [D Agent 0 I hereby certify that. all of the cletalis ana injormation 1 nave SumillUrlu kul caltvjru) 1ji auv— aFF—L—A —AU --Lat� LV LJJQ best of my knowledge and that all plumbing work and'i'ostallations performed unoer Permit Issued for this application will be in compliance with all pertinent provisions of the ssachu)etts ?1e Gas Cod7/� Chapter 142 of the General Laws. 1�d - In - Y: �tle I C i t y/Tjw—n OVED (OFFICE USE ONLY) Sianature of Liceng'e�umber Or Gas Fitter Plumber Z4,00 Gas Fitter License Number Master Joumeyman