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Date..:�5 .......
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that .......
.............. z . ...........
has permission to perform ........... S.;ff.-K4IAtT1; .... 64, cs ............
wiring in the building of ........... C6..�4,ILAP ........................ ..............
7 -
at ........ ; g I�oc ...... ................ . Nr� h Andover, Mass.
.........................
Fee- .............
Lic. No. ..15 .................
L r
Check.# 2-7112512S-
8062.
Official U
sc Only
it No. 2—
dpart'"
Occupancy and Fee Checkeid.
.60AR.D,OF FIRE PREVENTION REGULATIONS V�ev., 1/07]'
(leave blank)
APPLICATION FOR PERMIT -TO PERFORM ELECTRIC'
ALWORK
All w 4 -to be performed in accordanc'e with the Nizissachus'eas Electrical Code (KC), 527 CMR 12.00'
(PLEASE PRLVT Di LVK OR TYPE ALL L ' VFORMA TIOA9 Date:
ctor
City or Towit.of.: . AJok;rM P4, '1-o the Inve " ,of
By this application the undersigned, gives.riotice his or her.intention to pzi;form the electrical work desciibed,below.
ri
Num r)
Loc2iion (.Street,
Owner. -or Tenant CAI) 6 J) Teleph o ne.No. Y -16 -,--5 Vd,
Owfi�er�s Address
Is this -permit in conjunct tion with a building permit? Yes NO (Check Appropria
t.e Box)
Purpose of Building Utility Authorization No.
Existin -'Service Amps Volts Overhead Undard No. of Meters
New�Service Amps, Volts Overhead Undgrd No -of Meters
Number of FetderSr,and Ampacity
Location.and Nature of Prolposed Electrical Work- L 0,-� t 'a-, a SCCLv!�j 0� [—I rc 14 La rr-n-
S-revn
CDmoletion ofthe ff)ilawinv IchIp mnv ho wn�vpd hu AP 1"cnoefrir mf W;,or
NoiofR6ce_5sedLumifia1,res'�
No. of CeiI,Susp. (Paddle) Fans
_=7
No. o Total
Transformers KVA
No. of Luminaire Outlet
No. of Hot Tubs
Generators KVA
No. -of.Ldmina res
Swimminc, Pool- Above
gend, Cl d. El
0 0 I Emergency Ligfiting
I- '
battery Units
No. of -Receptacle Outlets
No. or oil Burners
IFIRE ALARMS,
jNo.orzones
No. orSwitches
No. of Gas Burners
!No. of Detection and
!..!tiatinga Devices
No. of Rano,
Oes
Total
No. of Air Cond. T ons
No. of Alerting Devices
No. of Waste, Disposers
Heat Pump
Totals:
I Number
I Tons
KW, 'No.
of Self -Contained.
Detection/AlertinZ Devices
No. of Dishwashers
S ace/Area Heatina, KW
p
Local unic pal Other
lion El
No. of Dryers
Heating Appliances KW. (Security
S�ystems:*'��
-=M5n51:0Zv'+ces or Equivalent
No. of Water KW
...�4eaters
No. of No. of
Signs Ballasts
Data Wiring:
No. of Devices c" Equivrltnt
No. Hydromassage Bathtubs
No. of Motors Total HP
1'elecommunic2tions Wirina:
No. of.Devicestor Equivalent
JOTHE]k:
qlraCn aaaglon y jae.strea. or as requirea py ine inspecror ol Yr tres..
Estimated Value of Electrical Work. 2_4, (When requiredalb'y1emIc'u1nicipal policy.)
Work to Start: Inspections to be re�uested in accordance with MEC . -Rule 10, and upon completion.
INSURANCE COVERACE: ( less waived by the owner, no permit for the -performance of electrical work may issue unless
the licensee rovides proof of liability insurance including "completed operation7 I e u
p _coverage or its substandal- q1 ivalent. The
s
undersigned certifies that such cpverage is in force, and has exhibited proof of sami� to the permit is uing office.
CHECK.O,NE: INSURANCE BOND, C1 OTHER, C] (Specify:)
I cerfij�, under thepains andpenalties ofperjury, that the information on this application is true and complete -
LIC. NO.:
FIRM NAME: r V Ce,—
Licensee: LIC. NO.
0 4�� Signature
L
6U_ 4
ffapplicablq, enter er(pt in zhe licenjinianker line.) ;7� Bus. Tel. No' 5
, 01 -M 150
Address: IJT AIL Tel. No.:
*Per M.G.L. c. 147, s. 57-61 secdeity work requires Department of Public Safety -S- License: Lic. No. oolq7s
OWNER'S INSURANCE "IV -ER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law own
By my signature below, I hereby waive this requirement. I am the (check one) er E] owner's aaent.
Owner/Agent
Signature Telephone No. 1PEPZNffTtFF.! S
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14
Date. . ;?
0�" TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that T ..................
has permission to perform ............
plumbing in(the buildings of ............ .........
atAe. . . . North Andover, Mass.
3b 4w '444-P
F e -e ......... Lic. No .......... ....
Check # PLUMBIWUNSPECTOR
5567
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUsETrs
Date
Building Location Hi PS- Cr —Ow-ners Name Les lie CjRiZc)jvf, Permit #
Amount 30
Type of Occupancy Owe 11
/I
New 0 �Renovation 0
Replacement Plans,
FIXTURES
Yes 1:1 No 19
(Print or type) Check one: Certificate
Installing Company Name T, 10 It ArA/ Corp.
Address 0 - Do "' i-
571 Partner.
/.AI,4j ReAlte A40- 01'94Z --
'Business Telephone qj (0 �� 5-- f:L,0
Firm/Co.
Name of Licensed Plumber: 7-0 M -'?04 r-1
��s% Insurance Cove ge: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy Mr Other type of indemnity Bond
Insurance Waiver: 1, the undersi gned, have been made aware that the licensee of this application does not have any one of the above
three insurance
i7nature 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 installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts 3tate.Plumbing Code and Chapter 142 of the General Laws.
(OFFICE USE ONLY
Type of Plumbing License
Maste Journeyman
ense i-4UMDer r .. 11
k
(Print or type) Check one: Certificate
Installing Company Name T, 10 It ArA/ Corp.
Address 0 - Do "' i-
571 Partner.
/.AI,4j ReAlte A40- 01'94Z --
'Business Telephone qj (0 �� 5-- f:L,0
Firm/Co.
Name of Licensed Plumber: 7-0 M -'?04 r-1
��s% Insurance Cove ge: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy Mr Other type of indemnity Bond
Insurance Waiver: 1, the undersi gned, have been made aware that the licensee of this application does not have any one of the above
three insurance
i7nature 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 installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts 3tate.Plumbing Code and Chapter 142 of the General Laws.
(OFFICE USE ONLY
Type of Plumbing License
Maste Journeyman
ense i-4UMDer r .. 11
-*p- -- -.- - z� -1- - �- � - 7 --" --A, �, 1, , --� �'-- - , .� t-1 - �. � " , ` _- - � - _ I
1*
a
Date. . .- 'q. -. ......
TOWN OF NORTH ANDOVER
'PERMIT FOR GAS INSTALLATION
K
This certifies that . X,...
has permission for gas installation
in the buildings of .......
at .................. North Andover, Mass.
..................
Fee�� ..... Lic. Noc
G S IN E TOR
Check 4 / ;!-/
4330
MASSACHUSETrS UNIFORM APPLICATON FOR PERAUr TO DO GAS Ffrr]NG
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Locations RX )4 #�/ I i4s c
Lesiie Cf0P,1?0AJe Owner's Name
New Renovation Replacement [M Plans Submitted
El LIJ
Date 4-3 -C)3
Permit #
Amount $ Cr)
(Print or type) bee one- Certificate Installing Company
Name—r- L1-41-t01Cg2111 ja4 Corp.
Address 97,�, Partner.
e-4 &j 4 e, -v c e 14 q C
.Business Telephone 2-71 6 Y!5- '� 5-10 Y Finn/Co.
Name of Licensed Plumber or Gas Fitter 7�Yvn os W-4 �& leq -a
INSLTRANCE COVERAGE Check one,
I have a current liability Insurance policy or it's substantial equivalent. Yes ID Noo
Ifyou have checked M, please indicate the type coverage by checking the appropriate box
Liability insurance policy 0 Other type of indemnity [3 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 F-1 Agent [3
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 installations peiformed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State Gas.Code�,an
�J ,d Chapter 142 of the General Laws.
VED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber ;t V � 33
Gas Fitter License Number
0 Master
[Z] Journeyman
mom
(Print or type) bee one- Certificate Installing Company
Name—r- L1-41-t01Cg2111 ja4 Corp.
Address 97,�, Partner.
e-4 &j 4 e, -v c e 14 q C
.Business Telephone 2-71 6 Y!5- '� 5-10 Y Finn/Co.
Name of Licensed Plumber or Gas Fitter 7�Yvn os W-4 �& leq -a
INSLTRANCE COVERAGE Check one,
I have a current liability Insurance policy or it's substantial equivalent. Yes ID Noo
Ifyou have checked M, please indicate the type coverage by checking the appropriate box
Liability insurance policy 0 Other type of indemnity [3 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 F-1 Agent [3
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 installations peiformed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State Gas.Code�,an
�J ,d Chapter 142 of the General Laws.
VED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber ;t V � 33
Gas Fitter License Number
0 Master
[Z] Journeyman