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HomeMy WebLinkAboutMiscellaneous - 41 WEST WOODBRIDGE ROAD 4/30/2018r m En rt 0 0 a n a LQ m x a a 17 Date.. el, �TZ TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACNUS� / /j r�/ This certifies that ft `A'3:" /:........ . has permission to perform ... .. ............. . plumbing in the buildings of .. G�. ............. at . !1f. .Ct./..rff.`�/����:f.. ...... , North Andover, Mass. Fee. �ic. No. ............................. . PLUMBING INSPECTOR Check # 6134 c ,t CS S� �9 MASSACHUSETTS UNIFORM APPLICATI F04,PERMIT TO DO PLUMBIN (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location "y/ W011E /Owners Named,&,v✓rW of Date Permit #�c�lt Amount New rl Renovation Replacement Plans Submitted Yes No ❑ FIXTURES (Print or type) Check nCertificate installing CompanyName ne/Ta0� hCorp FlPartner. Firm/Co. Name of Licensed Plumber: ld,-in{ Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 0--1; Other type of indemnity D Bond 0 Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above threeinsurance Signature Owner ri Agent n 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 performe under Permit Issued for this application will be in compliance with all pertinent provisions of the Ma chu ?ate Plu�mgode and Chapter 142 of the General Laws. BY Signature oi Licenseaum er Type of Plumbing License Title o�o7ss City/Town License Numoer Master ❑ Journeyman APPROVED (OFFICE USE ONLY. 3763 Date...v.�......��.�..... 4,-... 'z TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... .................................................................. K has permission to perform wiring in the building of .�. ...... �-�'��!� U:``?-........... at .....%.............. , North Andover, Mass. Fee.<5-P.............. Lic.No':� -v.;K�.....\. . .................... ELECTRICAL INSPECTOR Check # �irurt oa jau8(li $a6et�y BOARD OF FIRE PREVENTION REGULATIONS.527_CMR 12:00 official Use Only ' Permit No. ,3/ Occupancy & Fee Checked�� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Town of North Andover The undersigned applies for a permit to perform the electrical work described Date S 4, " ZD 6 2 To the Inspector of Wires: Location (Street & Number Owner or Tenant 0 r • Is this permit in conjunction with a building permit Purpose of Yeq�K EAsting Servi...��� Amps Volts New Service L... O ' Amps(9 Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical W No ❑ (Check Appropriate Box) Overheadh<" Overhead 6 - .Utility Authorization No. Undgmd ❑ No. of Meters Undgmd ❑ No. of Meters v --- v . -- -- — - Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ No. of Lighting Fixtures Swimming Pool grnd ❑ grnd ❑ Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No. of Di sal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Dishwashers S ce/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other No. of Dryers Heating Devices No. of No. of KW Local Connection Low Voltage No. of Water Heaters KW Stns Bailases Win' No. Hvdro Massane Tuds No. of Motors Total HP INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate type coverage checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Work$ Work to Start Inspection Date Signed under tnXP of /?r /) n�/ FIRM NAME_ \� /� LIC. NO. Z (y,%-► Address 10-A"c OWNER'S INSU E WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this regtirement Owner Agent (Please Check one) Telephone No. PERMITTEE $ (Signature of Owner or Agent) .o 0 Date .......................`'"`' � TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... u' t N ( o ......................................................................... has permission to perform '? t"'� `� ......................................................................... wiring in the building of ........... !;". ). `:'e. ................................................. f.;/ C7t.` A e. iq , North Andover, Mass. Fee ... 5:5�...... Lic. No..�`�..scqgt �i�R AAt` ........................................................... ELECTRICALlINSPECTOR Check # � � � � i 5386 ThECONIMONW AL7HOT' AL4SSFiL'HUSE'TI S' Office Use onl DEPAR73fflW0FPU&JCS4FEIY fir"" �j BOAROOFFIREPREVF1MONREGUL 77ONSM70MI20 Permit No. Occupancy & Fees Checked APPLICA77ONFOR PERMIT TO PERF ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUS S ELECTRICAL CODE, 527 CMR 12:00 Q r (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date ( J �/ O Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical wordescrib d below. Location (Street & Number) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes No a (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service z Amps 12��Volts Overhead M 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 r) Cil f,(-Cgom S GA^P r1, No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above J Below Generators KVA round El ground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals i No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP kUVF!roeCaw[ag- PlantantIDft ecltnternaIsatMaMft]SMCOOWLaws Iha,' acu MLiabt7ityhmaaroePbbcyin h*gCor VW Omw,Wor s&&WUagmabt YES NO IhavE&ftniWdva1dproofofsamelDdZO1>= YES F)mtawdleclodYES plea9em&*thetAxofoDveWby dleckir Il iNc � BOND omIx a ftweSpecily) WaklDS4rt hWx6mD*RequesbdRoo Vahteofflecmcal W6k $ �� a Fmal Signedund2rTieRmltiesofpc3W- - I�jd FIRMNAME �"T o &L„ A l V)SL D c,.3la�ae L aneNo. 3:5()-600f :' ©/ [ ^ E- Lioet>sae sigrLicffWN6 - 4' 6r- BuskmTel. No. 97 .4.7 3�Aqc/o f7 AML-3000 _ .c9- 1', < I /(s O) -t a .0 -?61( Alt Tel Na 1023 �z - -7 3 OWNER'SINSURANCEWAIVER;Iamawa<ethattheLmwdommthmtheir>mm=oovwgeoritsatmt oWwalatasmgnFedbyNbmc Li f CeoWLaws and drat my sig matin on d%pem M)1icahm waives this legtmemat (Please check one) Owner M Agent a Telephone No. PERMIT FEE $ signature of Owner or Agent Form of Notice of Casualty Loss to Building ved Under MASS. GEN. LAWS, Ch. 139, Sec. 3B TO: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectmen Town,,ofi;N. Andover ) ( Town of N. Andover ( addresses N. Andover, MA 01845 ) ( N. Andover, MA 01845 RE: Insured: Dorothy M. Pybus Property address: 41 West Woodbridge Road N. Andover, MA Policy No. 97 40338 51 00 Loss of 4/21/91 19 File or Claim No. WAP1 2549 Windstorm Claim has been made involving loss, damage or destruction of the above -captioned property, which may either exceed $1,000.00 or cause MASS. GEN. LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASS. GEN. LAWS, CH. 139, SEC. 3B is appropriate please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. Adjuster Title: On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. PATRICK J. DO'NOVAN ASSOCIATES, INC. 4/29/91 P.O. BOX 110 Signature and date WAKEFIELD, MA 01880