HomeMy WebLinkAboutMiscellaneous - 339 WAVERLY ROAD 4/30/2018 (2)N
A
Location 3 3 a \ A -JCA )4 ;2 (11 )e j
No. Date
TOWN OF NORTH ANDOVER
0
P.- Certificate of Occupancy $
41
Building/Frame Permit Fee $
Foundation Permit Fee $
CHU
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL
/14cluilding Inspector
f919- 47
25- 00 PAID Div. Public Works
I Location
No. Date
TOWN OF NORTH ANDOVER
0 Certificate of Occupancy $
Building/Frame Permit Fee $
CH Foundation Permit Fee
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
J TOTAL
Building Inspector
()9 98 08.47
25. 00 PAID Div. Public Works
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HOME IMPROVEMENT CONTRACTOR .
Registration 104530
a Type DBA
Expiration 07/14/00
CESATI CONTRACTOR'S
Michael A. Cesati
Cedar Street
Aorni"S7Raroa Haverhill MA 01830
DEPARTMENT OF PUBLIC SAFETY.
i,
C.ONSTROCTIDN SUPERVISOR LICENSE '
Numb N& ,Expires: Birthdate
C`S8812A w 04/28/2888 84/28/1956
Restricted -To.. 88
�,� �t�' MI£HREI R.;OfSRTI
187 CEDAR ST
HRVERHIII, MR 81831
N2 2 19, 7 7
U00
e—)
.........................
Date../7.1. e52 / '-') /
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
f
This certifies that .............
, , —Z'
.....................................................................
has permission to perform ... Z� ...........
.......................................................
wiring in the building of ........ ........ .........................................
....... . North Andover, Mass.
at.:� .......... �Kz .......... .......
Fee.... ..... . ..... Lic. No.&�, ................................................................
ELEc-rRicAL INSPWMR
Check # 1211
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
(f n Pwnw#a& o` ///a�a�tr�da�! For Office Use Only
(Rev. r7 /J
cc�� cc7] Permitt Num Number: L
1J#pa.lna<#nt a` }i,+# �irmc#e zy
Occupancy & Fee 15
BOARD OF FIRE PREVENTION REGULATIONS
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WO
(ALL WORK TO BE PERFORMED WITH THE MASSACHUSETTS ELECTRICAL CODE 527 CMR 12:00)
PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: D
City or Town of: kin ANDOVER To the Inspector of Wires:
By this application the undersigned gives notice of his or herint
entionto perform ttp.electrical work described below.
Location: (Street & Number) -33 �
Owner or Tenant: G k a) s AxouJA
c�
Owner's Address: JT2q-- C
Is this permit in conjunction with a Building Permit? Yes C/ No ❑ (Check Appropriate Box)
Purpose of Building: 31% 'e Utility Authorization #:
Existing Service: Amps / Volts Overhead ❑ Underground.❑ # of Meters
New Service: Amps 1 Volts Overhead ❑ Underground.❑ # of Meters:
Number of Feeders and Ampacity:
Location and Nature of Proposed Electrical Work:y&-n
No. of Recessed Fixtures
No. of Ceil: Susp. (Paddle) Fans
No. of Transformers Total KVA
No. Of Lighting Outlets is
No. of Hot Tubs
Generators KVA
No. of Lighting Fixtures 3
Swimming Pool: Above ground ❑ In Ground ❑
# of Emergency Lighting Battery Units
No. of Receptacle Outlets
No. of Oil Burners
J
Fire Alarms # of Zones /
# of Detection & Initiating Devices
# of Sounding Devices:
# of Self Co aired
Detectionounding Devices
No. of Switches
No. of Gas Burners
No. of Ranges
No. of Air Conditioners TOTAL TONS:
Local 10r Municipal Connection ❑ Other ❑
No. of Waste Disposals
Heat Pump Totals:
Security Systems:
Number: TONS: KW:
No. of Devices or Equivalent
No. of Dishwashers
Space /Area Heating: KW
Data Wiring, No. of Devices or Equivalent:
No. of Dryers
Heating Appliances KW
Telecommunications Wiring: No of Devices or
Equivalent:
No. of Water Heaters KW
No. of Signs: # of Ballasts:
OTHER;
# of Hydro Massage Tubs
No. of Motors Total HP
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 _pr000f of same to the permit
issuing office. CHECK ONE: INSURANCE V BOND ❑ OTHER 0 Please specify: //G��41
Estimated Value of Electrical Work
(When required by municipal policy)
Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion.
I certify, under the pains and penalties of perjury, that the Information on this application Is true and complete. /) d
Firm Name: v L Lam/%C rel c 60 —r*C eq LIC. # 3-3
Licensee: S /`� �y�✓H �/L Signature: y/ LIC. # 4 5l —33
p Q (if applicable, enter " empppt" in the lone num4 r line)
Address: JU f �f�C�E��/1/Q /A e7 /�(l �`� 10 4'4KBus. Tel. # Alt. Tel. #
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 ❑ OR Agent ❑
Signature of Owner/Agan+t: Telephone # PERMIT FEE: S