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Home My WebLink AboutMiscellaneous - 39 GRANVILLE LANE 4/30/2018O n O Z O < J r 6 m o �; P Z 0 m Date...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .... J....kA... CN..... i<:......4 ............... e . ................................. has permission to perform ....a,....{R.c t N.„�c? ............................... wiring in the building of ...... 1.-.0 ...................................................... at.......32.... 6:7R..qA.w.�..CIL .....�'............. ... . North An _over s. Fee .7�.:.)...... Lic. No�� . . .......... ....... ......... ....... ................. ELECTRICAL I SPE R +C I-7wg17/99 14:00 70.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer atece Use Only T t Gl hl LfZM IIIIUjU1a1± Of sh fi1MBtt PerMt No. 66 C 3 3qz a xnt of 11uhUt -am{P$g OCCupanry & Fee Checked BOARD OF i:iRE PREVENTION REGULATIONS !27 CAR 12:100 1 3194 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massacnusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date %N or Town of NORTH ANnOVER To the Ins c:or of Wires: The udersigned applies for a permit to pertoqp-the elec:rical warts described below. Location (Street 3. Number) Owner or Tenant Cwirier's Address Is ,his -m permit in ccnlur,c::on with a building Dermic: Yes — No (C`eck ,;poropna:z ?cx) Fur=cse cf Ewidirc S` I AlUtility Autrorization No. Ezis:ing Service Amos/cit OverreaD '_ Unccrnc i No. of Meters New Service Amos `/n,ts Cverr.eac — Uncgmc _ No. of Meters f Numcer at r9eders arc .micas::Y _ccaz,z,-, arc Nat -.;.re cf Prcccsec =:ec:, " I .vera Total .No. of No. _. _.;,-..r.g Cut:ets No. _. -_. acs � � K`:A No. of C.gnnng = stores Sw,rr.ming ? g ca) rna. .— :n- rr.c. — stns. i Generators KVA No. of Emergency ugntlrg No. _t=____:ac:e Cutlets No. ct :il _umers ; 3arery Units No ni Swrte^ ^utters No. or Gas __rners I FIRE .a AlvlS No. of _ones No. of Ranges TotalI No. of Catect:on arc Nr No. cf Air _cr.c. :cs in)tiaung ']aVICes o. of Cisccsals No.of "eat Total Total Tons C.'J nlo. of _.snwasners Scacerarea F-!eatlr.c KW Na. of Scuncmg cevices No. of Se)t Cznta)nea Owect:enrSouncing-evtces • I — Municicai — Othe No. v Criers Heat:-- •�avices KW _seal Cannec=n i No. ct No. of Low vcitage No. at '.•rater seaters ?Oil Sicrs 3aiiasts bvir.nc Na. ,ero .Massace .u=s ! No. of tactors Total -P _ I I INSUFaNC= C: `SER .GE. P•_rsuant :c the recturernents or'surn acr-sas ;eerai Laws I have a current '�acw y Insurance ?_tic/ nc:uc:Mg Czmc• tec Ccerattens C;verage cr -ts suestantial ecu)va)ent. YES = N0 _ nave su=rnir vall ..root cr same to :rte L t ic9. Y=j _ NO _ ifes' --U ,ave /. cxea YES. ;tease incicate :he tvCB t coverage :v crecxing :rte aocr „nate :a%. �' ✓ewe / ,rl f /2 v? , , INSURANCE BONO = OT'HER = tP`ease Sae :!y) 1 /L ` ��J / E:co)rauon •Dater samatea value of Eiec:neat 'Norx s Werx :a Star. Inscect:en Oats RacueVec: Rcugn SSgnea unser iris P��.p� tiesat;e ~ =i'nM NAME .9,/ YM li "ekICT 1F3 Jul 9- �r- T-T.� UC. O.fz�g� Licensee UPf'rF'gT�/ / �`✓�� 5,gnat s'e rc r�//I�. �� / &&w o0p 'Alt. -et. No. (/ o oa �� AQCress ® alt.�el. Flo. CWNER'S INSURANC='NAIVER: I am away :nat ins _:censee cues not nave :."is insurance coverage or its suostantiat eeuivalent as re- cuirea av .Massacnusetts General Laws. ane :nal my signature on :n:s _erm:t accttcattan carves tn)s reou)rement. Owner Age^ (Please cnecx one) erecrcr.e Na. PEFMIT PS_ 5 Sicr.ature ct Cwner or +Sena <-i5c5 - L Date...2? i ................ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION x pp This certifies that ..f....� has permission for gas installation ....:......... . in the buildings of .... r. t at ....>....'.. ! . `.... . .�............ , North Andover, Mass. r Fee.. Y' . ... Lic. No.....;"<.... ...... `�.... ! ...... .. ... . _ GAS INSPECTOR Check # 4' 3G i MASSACHUSETTS UNNORM APPLICATONFORPERMIT TO DO GASFITTING (Type or Print) //,Date NORTH ANDOVER, MASSACHUSETTS Building Locations 2 e--' (/ • Ile /` Permit # yo 3 6 L Amount $ Owner's Name New a-- Renovation ❑ Replacement ❑ Plans Submitted ❑ (Print Address 4 !J I a� X PU ✓1.-� U -v v -2 Business Telephone cf 1" n f '2 d Name ofLicensed Plumber or Gas Fitter N (-) xZV Cone. Certificate Installing Company a Corp. ❑ Partner. Firm/Co. INSURANCE COVERAGE Check one. I have a cunent liability Insurance policy or it's substantial equivalent. YesE3— No❑ If you have checked M .please indicate the type coverage by checking the appropriate box. Liability insurance policy 19— Other type ofn4'emnity ❑ Bond ❑ 1,. )� Owner's Insurance Waiver: I am aware that the licensee does not have the Insurgnce 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 ❑ Agent ❑ I hereby certify that all of the details and information I have best of my knowledge and that all plumbing work and instar compliance with all pertinent provisions of the Massachgo (OFFICE USE ONLY) Signature of l Plumber ❑ Gas Fitter Master Journeyman (or entered) in above application are tme and accurate to the %rmed ever Permit Issy for this lication will be in s ode �j Cha , er 14�jf the Laws. led Plumber Or Gas Fitter -g4 License um a -- a !!!!!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!!!!! (Print Address 4 !J I a� X PU ✓1.-� U -v v -2 Business Telephone cf 1" n f '2 d Name ofLicensed Plumber or Gas Fitter N (-) xZV Cone. Certificate Installing Company a Corp. ❑ Partner. Firm/Co. INSURANCE COVERAGE Check one. I have a cunent liability Insurance policy or it's substantial equivalent. YesE3— No❑ If you have checked M .please indicate the type coverage by checking the appropriate box. Liability insurance policy 19— Other type ofn4'emnity ❑ Bond ❑ 1,. )� Owner's Insurance Waiver: I am aware that the licensee does not have the Insurgnce 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 ❑ Agent ❑ I hereby certify that all of the details and information I have best of my knowledge and that all plumbing work and instar compliance with all pertinent provisions of the Massachgo (OFFICE USE ONLY) Signature of l Plumber ❑ Gas Fitter Master Journeyman (or entered) in above application are tme and accurate to the %rmed ever Permit Issy for this lication will be in s ode �j Cha , er 14�jf the Laws. led Plumber Or Gas Fitter -g4 License um a --