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Home My WebLink AboutMiscellaneous - 42 OLYMPIC LANE 4/30/2018 / 42 OLYMPIC LANE 210/106.6-0110-0000.0 I Date..... ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING 4L This certifies that .................M.......4.P� ........................................... has permission to perform ........ ................ wiring in the building of................I.... &..................................................... at... .............................. .North Andover,Mass. Fee..Y .......... Lic.No.2 .3 ....... ............... LE- CALMPEC7R Check It -Z�6 935-3 Commonwealth of Massachusetts Official /Use 2Only Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (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: 41•- 2 3 - /1*9 City or Town of: NORTH ANDOVER 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) 412 oLyr••Plc A PTN& A A1J0At m 0~p0VAJK Owner or Tenant %Asa-a F, &POP Telephone No. 970-387-664 Owner's Address 'VZ 04Y~P/C Is this permit in conjunction with a building permit? VesX No :. (Check Appropriate Box) Purpose of Building &014- Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: a 6 Completion of the followingtable maybe waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- o.o Emergency Lighting No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ of Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of Detection and No.of Switches No.of Gas Burners No. Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pum Number. Tons KW No.of Self-Contained Totals Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Si ns Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: + No.of Devices or Equivalent / OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. 1� Estimated Value of Vectrical Work:. 'CC) (When required by municipal policy.) Work to Start: 2 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C E GE: 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 proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: 71 irk.��E�� ,; -� Uj'r Signature LIC.NO.: 72-361!(Z- (If L361J(If applicable,enter "exempt"in the license number line) Bus.Tel.No.: Address Alt.Tel.No.: q6, *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURE W VE . 1 am aware that the Licensee does not have the liability i rance coverage normally required bylaw. Bi reelow,I hereby waive this requirement. I am the(check one owner ❑owner's a ent. Owner/Agent ��r 9 Signa - Telephone No. -tW!� PERMIT FEE: $ HAUL LIC # 777 $100 1996 STEWART'S SEPTIC TANK SERVICE INST LIC # 659 $200 1996 47 RAILROAD STREET BRADFORD, MA 01835 508-372-7471 May 3, 1996 NO ANDOVER BOH TOWN HALL ANNEX t 120 MAIN STREET NO ANDOVER, MA 01845 3 �� PH# 508-682-6483 `JA 508-688-9540 ** FAX 508-688-9556 Dear SIRS: The following is a list of properties that we pumped in your town. In accordance with TITLE V regulations, we are complying by sending you the following on a monthly basis, if need be. If we didn't pump, you will not be notified. PUMP DATE ADDRESS GALLONS 04-01-96 197 ABBOTT STREET 1,500 105 WINTERGREEN DRIVE 11000 04-02-96 A 42 OLYMPIC LANE 11000 04-04-96 A 71 PENNI LANE 11000 04-06-96 492 SHARPNER'S POND ROAD 11000 A 39 HAYMEADOW ROAD 1,500 04-08-96 498 WINTER STREET 11000 187 SOUTH BRADFORD 11000 04-09-96 A 495 REA STREET 11000 04-10-96 A 706 FOSTER STREEET 11000 04-11-96 A 83 CAMPBELL ROAD 11000 04-11-96 A 43 CHRISTIAN LANE M 1,500 04-12-96 7 HAYMEADOW ROAD 11000 1577 SALEM STREET 11000 04-13-96 278 BARKER STREET 1,000 HEAVY 04-16-96 A 30 BRENTWOOD CIRCLE 11000 04-17-96 A 27 COACHMAN'S LANE 11000 04-18-96 369 HIGH PLAIN ROAD 11000 28 CEDAR LANE 11000 A 121 CAMPBELL ROAD 11000 04-19-96 A 160 BRIDALPATH LANE 2,200 04-20-96 A 200 RALEIGH TAVERN LANE 11500 A 1 GARFIELD LANE 1,800 10h12v0s0b3T Advantage Claim Services 2100 Lakeview Ave . Dracut, MA 01826 Form of Notice of Casualty Loss to Building Under Mass Gen Laws, Ch. 139, Sec. 3_B To: Building Commissioner orv� Board of Health or Inspector of Buildings Board of Selectmen Town Hall address Town Hall No. Andover, MA 01845 No. Andover, MA 01845 Re : Insured: John A Collins Property address :' 42 Olympic Lane No. Andover, MA 01845 Policy # : HP2267865 Loss of : 04/02/04 File or Claim No . AD 6973 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. Glenn Guarente Title : Adjuster On this date, I caused copies of this notice to be sent to the persons named at the addresses indicated above by first class mail . Signature and date