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Home My WebLink AboutMiscellaneous - 30 SPRUCE STREET 4/30/2018N) Date ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ........... .................................................................................. V /Yhas permission to perform ... ... 4� 0 J1 ................ -1 ............... ....................... wiring in the building of at ... 1:A).JP ........ ...... . North Andover,, Mass. -4 Fee.. // /�) .................. Lic. ... gu Z'.. ELEMICAL INSPECTOR Check # # i mmm9powunlc*�,, Commonwealth of Massachu etts offffill�icial use only Department of Fire Servic s Permit No. -5c:p- UV 1 BOARD'OF FIRE P�tEVENTION REG LATIONS Occupancy and Fee Checked f �Q a [Rev. 11/99) (leave blank APPLICATION FOR PERMIT T ERFORM ELECTRICAL WORK All work to be performed: , i=n accordance with the chusetts Electrical Code (NE ), 527 MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2 City or Town of: r- le_r To the Inspector of ices: By chis application the undersil a gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 30 cple-- Owner or Tenant `—.^ \Cj►� j ,�� r`r� cry Telephone No. Owner's Address Ci)l11(l,F� Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building (Check Appropriate Boz) `, Utility Authorization No. Ezisting Service Amps / _Vo is Overhead ❑ Und rd g ❑ No. of Meters _ New Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity INSURANCE COVERAGE: Unless waived by the owner,( ocperm'it tionafor/mof Wirej. the perforance of electrical l i desired, or as requiredwork mayeissue 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 BOND [;� OTHER ❑ (Specify:) Estimated Value of lectrical Work:(Expiration Date) (When required by municipal policy.) Work to Stang -----'—" o CIS Inspections to be requested in accordance with NEC Rule 10, and upon completion. I certify, under the pains and penaltiesof FIRM NAME: perjury, that the information on his application is true and complete- _ gcCo g � \v., , , Licensee:�o�..., LIC. NO.: f� •� 4, ° � Signature '-- f LIC. NO.: E (I applicable. enter "e.Temp!" in the license number line.) Address: Q� o Foxb ocv M f\ Bus. TcL No.' sOe's`-+3- S��g 0 2o3S Alt. Tel. No.: J"'o'b - 9 t,'z- OWNER'S INSURANCE WAIVER: tam aware that the Licensee'. does nor hm,e die Iia t tty insurance coverage norma�y required by law. By my signature below, I hereby waive this requirement. I am the (check one ❑owner Owncr/Agent ❑ owner's a cru. Signature Telephone No. PERMIT FEE: $ Date. . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ... has permission for gas installation, / (-' / ....................... in the buildings of . . . . . . . . . . . U at .... ...... North Andover, Mass. Fee L/ic. No. GAS INSPECT00( Check # 5 Ij 41. 5 0 4� u.w MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) N.ANDOVER City, Town Building 30 SPRUCE ST AT: Location New Renovati n ❑ Plans Submitted Yes ❑ No ❑ Date 02/24/05 Permit # S3 -04/1"5 - Owner's MARGORIE RICHARDSON Name Type of Occupancy: RESIDENCE Replacement ❑ (Print or Type) Installing Company Name E. Osterman Propane Inc. Address 22 Legate Hill Road P.O. Box 722 Sterling, MA 01564 Check One: 13 Corp 042553302 ❑ Partnership ❑ Firm/Company Certificate Business Telephone 978-422-0204 Name of Licensed Plumber or Gasfitter 1 hereby certify that all of the details and information I havesubmitted (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 State Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Sipoature of Owner/ Agent n I have a current liability insurance policy to include completed operations coverage. BY TYPE LICENSE: Title ❑Plumber Signature of Licensed Plumber or Gasfitter City/TownGasfitter r - - --- APPROVED (OFFICE USE ONLY) lb Master '! � "-� S'p 0 Journeyman License Number Y • (Print or Type) Installing Company Name E. Osterman Propane Inc. Address 22 Legate Hill Road P.O. Box 722 Sterling, MA 01564 Check One: 13 Corp 042553302 ❑ Partnership ❑ Firm/Company Certificate Business Telephone 978-422-0204 Name of Licensed Plumber or Gasfitter 1 hereby certify that all of the details and information I havesubmitted (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 State Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Sipoature of Owner/ Agent n I have a current liability insurance policy to include completed operations coverage. BY TYPE LICENSE: Title ❑Plumber Signature of Licensed Plumber or Gasfitter City/TownGasfitter r - - --- APPROVED (OFFICE USE ONLY) lb Master '! � "-� S'p 0 Journeyman License Number