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HomeMy WebLinkAboutMiscellaneous - 34 MOLLY TOWNE ROAD 4/30/2018i HORTIy o .' Date's ...... ". . . f' TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING �SACMUSc J --- This certifies that ... ......................... has permission to perform . l .. . •.."......... . plumbing in the buildings of 4��. �...... ""'.. . , North Andover, Mass. Fee.,�7.71 ... Lic. No. ............. PLUMBING, INSPECTOR Check # j�'� � L 7319 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date Building Location Owners Name e j_NQA.p0 i Permit #�23L Amount 7 ` Type of Occupancy N1.6 New 0 Renovation [3 Replacement [3 Plans Submitted Yes F] No (Print or type) Installing Company Name CUNc-,M i cc, o. --:r� Address I-1Gu &L,.&e� 4 Business —t �, - Lt t Check one: Certificate El Corp. ;ko Partner. Firm/Co. Name of Licensed Plumber.�- Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy) Other type of indemnity 11 Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature 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 State Plumbing' din Chapter 142 of the General Laws. By: 71gna 01 Licenseaum oer Type of Plumbing License Title l t 35�� City/Town icense um r Master Journeyman APPROVED (OFFICE USE ONLY i • -..-�-------------------Iwo - (Print or type) Installing Company Name CUNc-,M i cc, o. --:r� Address I-1Gu &L,.&e� 4 Business —t �, - Lt t Check one: Certificate El Corp. ;ko Partner. Firm/Co. Name of Licensed Plumber.�- Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy) Other type of indemnity 11 Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature 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 State Plumbing' din Chapter 142 of the General Laws. By: 71gna 01 Licenseaum oer Type of Plumbing License Title l t 35�� City/Town icense um r Master Journeyman APPROVED (OFFICE USE ONLY Date....`'. 1. P- ° �'.... . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ..... I ....... has permission for gas installation .. . `�............. in the buildings of : -�' . . at �... �' 1..T -K �` North Andover, Mass. r� Fe . �. ... Lic. No..../ .-.. �— ......... C 'GAS INSP6C{OR Check # /0,5- 5931 D,5" 5931 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date '3 NORTH ANDOVER, MASSACHUSETTS Building Locations Permit # Amount $ Owner's Name (i � NS�ry ` c n� New © Renovation Replacement Plans Submitted v (Print or type) Che k one: Certificate Installing Company Name CpnnC-� Tu�l-x W:74, c— Corp. i Address l r2c, k (�-�� c S�' 3 , �3 Partner. 1 t,a c V-� IN- p 15 a c� Business a ep one E] Firm/Co. Name of Licensed Plumber or Gas Fitter C-,-)A-Uk M,0, tk.", INSURANCE COVERAGE Check one: 1 have a current liability Insurance policy or it's substantial equivalent. Yes ® No13 If you have checked Les, please indicate the type coverage by checking the appropriate box. Liability insurance policy D 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 Aeent n.... _ ri . _ r71 - -- -- ­­ � -• ­ • -- -. .....,����a����� I uavu suumiaea for enterea) 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. VED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber Gas Fitter License Number ® Master Journeyman Ed U a �; a o m x a z F dd O z x z F �, a a a F z x p O Cw7 w > F w Z x Fx W W �' V m > z O F z U O x x O x 3 0 a o z> g a uFi F o SUB -BASEMENT BASEM ENT 1ST. FLOOR I 2ND. FLOOR J I 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR v (Print or type) Che k one: Certificate Installing Company Name CpnnC-� Tu�l-x W:74, c— Corp. i Address l r2c, k (�-�� c S�' 3 , �3 Partner. 1 t,a c V-� IN- p 15 a c� Business a ep one E] Firm/Co. Name of Licensed Plumber or Gas Fitter C-,-)A-Uk M,0, tk.", INSURANCE COVERAGE Check one: 1 have a current liability Insurance policy or it's substantial equivalent. Yes ® No13 If you have checked Les, please indicate the type coverage by checking the appropriate box. Liability insurance policy D 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 Aeent n.... _ ri . _ r71 - -- -- ­­ � -• ­ • -- -. .....,����a����� I uavu suumiaea for enterea) 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. VED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber Gas Fitter License Number ® Master Journeyman Date ..... TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING Thiscertifies that ......................................... ................................................ has permission to perform...:.- .:............................................................. wiringin the building of ................................................................................... at ....... 0 .... �./. ....... —2. ... ............ North Andover, Mass. Fee ... L i c. N o -A- ?It) 9Z ....................J...."` ........... ELECTRICAL IkSPECTOR'**- Check # 1-2- '.,- -.>-, 7252 1 _=*0 gl Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No.a�� Occupancy and Fee Checked [Rev. 9/051 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 81,,4 &4�.l 16 �O % City or Town of. ) ,Wdbo /,--z, To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction withming permit? Yes 2 No ❑ (Check Appropriate Box) , Purpose of Building MffZJ F' Utility Authorization No. , 3 l p 6 2 "l Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service ems--= Amps 196 / 1/0 Volts Overhead ❑ Undgrd No. of Meters I Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the followine table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans o. o Transformers Total KVA No. of Luminaire Outlets No, of Hot Tubs Generators KVA No. of Luminaires 1 Swimming Pool Above ❑ n- ❑o. rnd. grnd. of Emergency Lighting Battery Units No. of Receptacle Outlets a No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches y© No. of Gas Burners o. of Detection an Initiating Devices No. of Ranges % No. of Air Cond. j Tonal No. of Alerting Devices No. of Waste Disposers Heat Pumpumber Totals: Tons W No. o elf -Contained Detection/Alerting Devices No. of Dishwashers f Space/Area Heating KW Local ❑ Munic'pal Connection ❑ Other No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. o Water KW Heaters o. o o. o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications No. of Devices or Equivalent firing: OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. 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. 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 cover ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and Renafties of perjury, that the information on tl is application is true and complete. FIRM NAME: / <9a L i o LIC. NO.:,2,3,P92_ Licensee: `�G/.L�l Signature LIC. NO.:C2 ' Z (If applica a enter empt" in the license number line.) Bus. Tel. No.: 97 Address Qul (�Q Alt. Tel. No.: *Securi System Contractor License required for this work; 46plicable, enter the license number here: 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 agent. Owner/Agent PERMIT FEE. $ Signature Telephone No. i 7V ,3 — r b —D pn't 9 Ll WA V -e - T- t;r-C9 -7 /�� OJT �$ aRul i I I 1 9 1 1 1 1 1 1 1 1 1 .3 w � I \ @@ as a \ Nis RM wF- a O\ - z 4 n w all. s � a: AasN $so s=_ ebhbb s3o tiyHhRh�a$ m i AF ��p I to pd i N� R iii n$�a 6 I If -- d j� g �� iWo., � R I zal 7 r F- O g 0I O m at PIE i • 2 >�4 _.. rig s3 I \ Czw�jZk <f €� ° ,a:' g grim �_ Q R` w a Q � a A I A ♦ T O W N n �o t' w w "E =R< g k o d d R N o a a b z mUR 0 4 a zL w Z w Q res mdJ� a aw d 2 w 0 z s z 3 °v~iw° o O z Q w= 06 � QLLJ a' O Cn z Z. 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