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Home My WebLink AboutMiscellaneous - 31 Belmont V" CAJ 1� J c� .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING S US This certifies that .......... .............................................................................. has permission to perform_ .... ............................................... A wiring in the building .......................................... J ....... ........ . ...!�4..��,- - .... ,North Andover,Mass. ........... .. Fee�.............. Lic.No�&A;Mf ...... ................ ''--'ELECTRICAL INSPECrA Check # 57L5 JIM UU1V1iY1U1v rrr ILAI13(Jr DEPARTAIEWOFPUBIICSAFETY Permit No. BOARDOFFIREPREVENHONREGUT4T7ONS5r MRl2'W o Occupancy&Fees Checked APPLICATTONFO ERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL FORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permi to orm the electrical work described below. Location(Street&Number) / /v j — Owner or Tenant Owner's Address < 7 O 7 - Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building ildin A--/�IL- Utility Authorization No. T Existing Service Amps� Volts Overhead F-1 Underground ID No.of Meters New Service Amps� Volts Overhead =3 Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work - No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above .Below Generators KVA gMround ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units 1 No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP niER- hrxttanoeCoverag�.Pla�arR6othetagtmel�of�di>setlsGalaalLaws IhaveaataatLiabtli<ylrmaataePtCyindrhgConlplere Covaageoritsstlbstanbaltxltrivalalt YES NO jIhavesubmB�dva6dptoafofsamebtheOffici~YES >Iyvunaa•eedleclodYES,pleaseittdic&thetypeofoovaWby d=kbgdr booL , INSURANCE \\ BOND MIER �+ -7-67PA-1- � Estim*dvakr f�Wcik$$ WOlklostalt hWeclimDaleReq Roo Furl SigledtalM�iePtrlaltiesof 1~1RMNAME /V Lxr=NTa Loertsee(�H-C�' �3iy l rJ sig>ahae . LieNo D , Busii=Td Na m_ _ 1''I`)/ D ALTdNo. ZZL -31''A OWNER'SINSURANCEWAIVER;IamawarethattheI kimsedoesmthavetheirmaarcecoverrcritssubstanialegdvablasle uledbyMassadlusmGerlawLaws anddatniysgraueenthispem-affficabmwaivesthism mt:rnalt (Please check one) Owner a Agent Telephone No. PERMIT FEE$ i signature of Owner or gen I=UU[V1LV1U[v VVVAW 117 Ur iV1tU3„3ftt1nvaa,.A I L3 �••-- DEPARTA17MOFPUBLICSAFEH Permit No. ��QS BOARDOFFMPREVENHONREGULWOIVSM7aMIZO o, Occupancy&Fees Checked APPLICATTONFO EI MffTO PERFORMELECTRICAL WORK 0ALL WORK TO BE PERFORMED ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL ORMATION) Date �— Town of North Andover To the Inspector of Wires: The undersigned applies for a permi to orm the electrical work described below. Location(Street&Number) 8 M /v 7 T k= Owner or Tenant PY t?7-7CArf A L t A Owner's Address < 9 7r 7 D7 Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building a ` F- -/,/L-`,t7--(- -/ Utility Authorization No. Existing Service AmpsOverhead Underground No.of Meters New Service Amps Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work er 0 l L L- f Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA f Lighting Fixtures Swimming Pool Above Below Generators KVA round PrOund ri f Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units f Switch Outlets No.of Gas Burners Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones O Tons Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices Dishwashers Space Arca Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices _ �ryers Heating Devices KW Local Municipal Othe Connections Pater Heaters KW No.of No.of 1 Signs Bailasis fro Massage Tubs No.of Motors Total HP � ,,y,,r�PlmuatltbdletaquuarlafS�,,,,,,,t�� GalaelL3W3 LtabtTlyhstr®ttaePo6tyarlidngCample� COvaa�orffialbslaliiale�trivdlalt YES ® NO vaGdp1oefafsamebihe0llioe YES lr)uuhmdrdkedYES plweirri drtypeeftx by box. BOND M OTIm EAm*dVatleofE1xbxWWc&$ WakeSM kEp"mDE&ReqlxWd xalgn rural J FR11V ME� �L ty�01� Li)=No. � C •�3 I�oanee►u�+CGQ i Z Gi u : f r Sigrlaaae . L;oe WM Lr D Btsk=Tel.Nb.P� 6 'U ✓- D L At Tel No. USJNSL�RANCEWAIV!R;lamaw. I iomse,loffimthmIlvirisuatecovelaWoritssubst3 a arddUrMVxanaid&pwrit4*bmwai esdism na � b5'MassadnsensC�eleralLaws metlt (Please check one) Owner 1:3 Agent Telephone No. PERMIT FEE$ signature of Owner Of Agent Date.. . . .. .. . . . . NORTIy o= '` TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION s a SAC US h This certifies that ... ... . . . . . . . . . . . . .. has permission for gas installation . . . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . .-3-/. . . !.'".f �.. . . . .I.. . . . . . . . . . ., North Andover, Mass. Fee. . '. `. . . Lic. No..% . . . . . . . . . . . . . . . . . GAS INSPECTOR Check# 2. y 3584 ao MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING �t,Type or print) Date NORTH ANDOVER, MASSACHUSETTS -2 Building Locations c�l �2`tM ✓if Per M74# •� `S^ Amount S X0 r Owner's Name J o.Lore-nGe— 1 eyl dew Renovation ❑ Replacement Plans Submitted ❑ 1 jW :5 w _ U.1 Z -. -r =t C — suaSEM ENT — — — — — — 1;r'A SE .vt ENT 1sT . FLt) 0--R-- 2 R, D . FLOUR JF D . FLO U R -4T II F L O O R 5T IJ F L. 0 0 R 6T II FLOOR 'T 11 F L O O R ST I1 F1, n 0 R Pint or type) Check one: Certificate Installing Company Name Andover Plbg. & Htg. Co.. Inc. Corp. 9199 ,adress 20 Agean Dr., Unit-10 ❑ Partner. Methuen. Ma. 01844 Business Telephone (978) 685-8383 ❑Firm/Co. game oFLiccnsed Plumber or Gas Finer George LaRote INSUPLANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ I f you have checked ves,please indicate the type coverage by checking the appropriate box. Liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ Owners insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 ofthe Mass. General Laws,and that my signature on this permit application waives this requirement. >s Check one: j Si2narure of Owner or Owner's Agent Owner ❑ Agent ❑ '.. hereby certify that all ofthe details and information I have submitted(or entered)in above application are,_ttue._and accurate to the. best of my knowledge and that all plumbing work and installations perto ed under Permit Issued for this application will be in compliance with all pertinent provisions ofthe Massachusetts State G" Code and Chapter 43 ofthe General-Uws. BwIgnature of icensed Plumber Or Gas Fitter Title dPlumber 9983 C rv,Town ❑ Gas Fitter tcense 1 umoer tvlasie: -�PPRUV L-D io i,nc1:USE t)NI,Y) Journeyman