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Home My WebLink AboutMiscellaneous - 301 JOHNSON STREET 4/30/2018 301 JOHNSON STREET 210/097.0-0027-0000.0 \\ i t s Date...`�.'�......:............. t NOR7M 1 3:;•t;�`` ;•�."�,AL TOWN OF NORTH ANDOVER O P r PERMIT FOR WIRING $AcHueet This certifies that - -�-- .. ...........` ............................................ ................................... If, has permission to perform ........ . ................................. ............ wiring in the building of........fir<p ............!:..:::...................... ?r f �' -n-�— -- -� .... ,North Andover,Mass. Fee"' .l...... Lic.NoA &. 4?...................... . .................................................... .. ELECTRICAL INSPECTOR U ' rya/ Check # 8075 4 C ! L Official Use Only or►unontuea o a�sac effa 1mv cc� c7 Permit No. e(J¢Parfinenf o��ire Services Occupancy and Fee Checked�tJ BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with.the Massachusetts Electrical Code C),52a CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INF ON Date: „( (l C1 City or Town of: / ) Q 0.4) To the Insp for of Wires. By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) --30/ --�U pi Owner or Tenant ,+�' Liza do I is Loone No. Owner's Address :'/)�n t? 111 Is this permit in conjunction with a buildi g perm0 Yes ❑ No ❑ (Check Appro riat Box y �? Purpose of Building ) X1'1:' I Utili Authorization No. Existing Service Amps / V s 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: �0Erwice ro Completion o the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.of Total Transformers KVA ! No.of Luminaire Outlets No.of Hot Tubs Generators KVA 3 No.of Luminaires Swimming Pool boveIn- o.of Emergency Lighting nd. ❑ grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.of Detection an Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No,of Waste Disposers eat Punt _um er ,ons o.oSelf-Contained Totals: Detection/AlertingDevices No:of Dishwashers Space/Area Heating KW Local E] Municippl El other Connection No.of Dryers Heating Appliances KW ecuri tYSystems:* No.of Devices or Equivalent No.o Water o.of No.o Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. t Estimated Value of E ctrical Work: (When required by municipal policy.) Work to Start: Iz— Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE RAGE: 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 covera is in force,and has exhibited proof of sam to the j�rmit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) /� �/� . I certify,under the paw and pe aloes_,�p^erjury,(hat the information on this application is true and complet�j�j��' FIRM NAME: �`JU UfLt. ` i ItC. LIC.NO.14, Licensee: OL' .J b Signature LIC.NO.: (If applicable,ente "exe,((�� t"in the license n r lin Bus.Tel.No.•� �2 Address: , Y),i G`Zit 7 h L{f Alt.Tel.No.. ` *Per M.G.L.c. 147,s.57-61,securi work requires 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 one ❑owner ❑owner's a ent. Owner/Agent `_ Cic-1 Signature Telephone No. PERMIT FEE: V� . t i 1 r V 1 Date.. . . .?.r c �. ... .. OF NORTH 14, 4. TOWN OF NORTH ANDOVER ! PERMIT FOR GAS INSTALLATION SACMUSEtth This certifies that . . . . 17 ! . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installatitSn . . . . . . . . . . . . . . . . . . . . . . . in the buildings of . . . . . ..� A �.o"/ . . . . . . . . . . . . . . . . . . . at . . . . ..I?. t. . A f.`h � . . . . . . . . . . . .. North Andover, Mass. .) .0 G_ 3 r Fee. . .� . . Lic. No.. . . . . . . . . .-:^ . . . . . . �' GAS INSPECTOR Check# 591:0 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date /V 7 NORTH ANDOVER,MASSACHUSETTS Building Locations 3 U 4,J a'11- Permit# S ! YU Amount$ Owner's Name S �z/CC /V pl / New Renovation Replacement Plans Submitted OG (A Q O w x C = O z w w z w x z o a x > d c7 F z Er Z x w a w 0 w E• w H x Z y w C7 O > w < w > w °� z a z Q O O w a O uFi z x O x 3 A c5 .a v x > A a H o SU B-BASEM ENT BASEMENT f 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) j he Ck one: Certificate Installing Company Name � Corp. Address (J 19 x —>-t,U i E] Partner. &,11� U ✓ �s2 -Zc/� , usmess I a ep one ?io Firm/Co. Name of Licensed Plumber or Gas Fitter ��) � ( ��2 �c --V INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. yes Q/ No 13 If you have checked ves,please indicate the type coverage by checking the appropriate box. Liability insurance policy 13-*-- Other type of indemnity 13 Bond 13 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 13 Agent 13 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 p rformed under Permit Issued for this application will be in compliance with all pertinent provisions of the Mass ac sett Sta Gas ode and hapter 142 f the Ge al Laws. By: ignature of Licensed umber Or Gas Fitter Title ff-Plumber City/Town [:3 Gas Fitter License NunMer Master APPROVED(OFFICE USE ONLY) [3 Journeyman