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Home My WebLink AboutMiscellaneous - 35 SHANNON LANE 4/30/2018O O �`Date...�J l �v � -o 6 4 6 .............. I TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .:..!....... 1 . F .....(. -?.........J . `................... ................... has permission to perform ......:..... �4. 1. �l.l.......� .. 5 ................................. wiring in the building of r j �` l� tat ..... .1........` .`? ��.t �........f �............ ...orth Andover, ass. Lic. No. ........,..................... V LECTR[CAL IN�PECTOR Check # � �l / WHITE: Applicant CANARY: Building Dept. PINK: Treasurer L 9 Z. Commonwealth of lVMassachu?e-tts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS FOfficial Use 0n1 41 Pcniiitd Fee Checked [Rev. 11/991 (leave blank) td APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusens Electrical Code (MSCI 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Da t e: C� C- 0, � 0 0 6 City or Town of-. A)cLO 1lPf' _ 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) 5 Owner or Tenant m e S I r e- b,b 4, Telephone No. Za S_ as .1a Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No 21 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existin; Service Amps / Volts Overhead ❑ Undgrd ❑ New Service Amps / Volts .. Overhead ❑ Undgrd ❑ of Detection and Initiating Devices Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work - 10 No. of Meters No. of Meters L-0 r ►'f') Completion of the followinz table may be waived by the InsDector of iFires. No. of Recessed Fixtures No. of Cert-Susp. (Paddle) Fans ITransformers No. of Total KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above ❑ n- ❑ Swimming Pool grnd. grnd. o. o g Emergency Lighting Batten Units b b No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners INo. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices b No. of Waste Disposers Heat Pump Totals: Number I Tons JKWNo. of Self -Contained Detection/Alerting, Devices No. of Dishwashers Space/AreaHeating KW . Local tl-❑ coon Municipal [I Other No. of Drvers Heating Appliances KW unty ystcros• > 'cesvvf Equivalent No. of Water KW Heaters No. of No. of I Signs Ballasts Data Wiring: Na of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or E uivalent OTHER: Attach additional detail if desired, oras required by the Inspector of lVires. INSURANCE COVERAGE: Unless waived by the owner, no permit for die 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 proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work (When required by municipal policy.) (Expiration Date) Work to Start 1 d M Inspections to be requested in accordance with NEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on th s"application is true and complete. FIRM NAME: ADT Security Scr%-ices III Morse Street, Non4odl. MA 02062 LIC. NO.: 1533C Licensee: John S. Bassett Signatur / LIC. NO.: 1533C afapplieable.enter "exempt "in the license number fine.) Bus. Tel. No.: — 1 Address: Alt Tel. No.: 603-594-.59 resi OWNER'S IN! required by law Owner/Agent Signature JRANCE WAIVER: 1 am aumm that the LiLensee does not have the liability insurance coverage normally ONLY By my signature below, I Itereby lt-an'e this requirement. 1 am the (check one) ❑ owner ❑ oi�mer's agent. Telephone No. PERMIT FEE: S 0.5 \\ + MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING y t ((Type or print) of NORTH ANDOVER, MASSACHUSETTS Date _ Cc Building Locations C,h n cs r t L Permit # c� G Amount Owner's Name �' b b New Renovation Replacement Plans Submitted L, FIXTURES (Print or type){{�� Check one: Certificate Installing Company Name P` a G- � � a r e� ►� c' S Corp. Address » V' h f—: S --\, , Partner. 1�)car r � Business Telephone y cg j — p ? 1 ��Firm/Co. Name of Licensed Plumber: <? ),e cs -W- CA to 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 rl 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 chusetts State Plumbing Mde and,Chapter 142 of the General Laws. By: bignatUre o icen�P um er Type of Plumbing License Title I C ci '� - City/Town License NumFer Master Journeyman APPROVED (OFFICE USE ONLY •M i ilk►/....M.-.M......-....1•1 MMMMI MMOMMMMMMOMMOOMMMOMMMMOMM (Print or type){{�� Check one: Certificate Installing Company Name P` a G- � � a r e� ►� c' S Corp. Address » V' h f—: S --\, , Partner. 1�)car r � Business Telephone y cg j — p ? 1 ��Firm/Co. Name of Licensed Plumber: <? ),e cs -W- CA to 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 rl 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 chusetts State Plumbing Mde and,Chapter 142 of the General Laws. By: bignatUre o icen�P um er Type of Plumbing License Title I C ci '� - City/Town License NumFer Master Journeyman APPROVED (OFFICE USE ONLY Date.......... 3630 '�<<��•° �: tia TOWN OF NORTH ANDOVER x9ft PERMIT FOR PLUMBING FE S�cmus This certifies that..., has permission to .perform plumbing in the buildings of_. -l''................................ S at.. ` ...... , North Andover, Mass. m ut/o Fee'�� ... Lic. Nel9af . . PLUMBING INSPECTOR Alf - �S WHITE: Applicant CANARY: Building Dept. PINK: Treasurer