HomeMy WebLinkAboutMiscellaneous - 49 FERNWOOD STREET 4/30/2018 J
i
Date�L ...........
ViORTPI
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
4
SSA US
This certifies that ......./
. ..............f.,... ......................................
haspermission to
10.
wiring in the building of..... ...............
at... ................................ ............ .North Andover,Mass.
'ee —1......... Lic.No&Yo-- ..........
ELECTRICAL INSTE�
Check #
6
Commonwealth of Massachusetts Official Use Only
Department of Fire Services Permit No.
Occupancy and Fee Checked AJ
BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] 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: S-f t— C> C,
City or Town of: tVd0W r 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) y-jrn Wc1�eQ S�"
Owner or Tenant fl2 e Telephone No.99,? i�;r5-96-0,Y
j
Owner's Address t6 rz1 L.=]
Is this permit in conjunction with a building permit? Yes ❑ No 14-- (Check Appropriate Box)
Purpose of Building Pus, Utility Authorization No.
Existing Service /Oc) Amps A / Volts Overhead [L-,' Undgrd❑ No.of Meters
New Service J(*_ Amps /00 /C5,L/O Volts Overhead Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: W,0 tf
C�4 H.W Il �cj tit n�sl
Comple n of the followin table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Tota
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ o.of Lmergency Lighting
rnd. grnd. Batter 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.o 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.o No.or-- Data Wiring:
Heaters Signs 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.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: !q 06 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 covera 's 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: O ?722mLIC. NO.: tl I/7-
If
Licensee: Zofy 7— T�-77Ct--d Signature
(If applicable, enter "exempt"in the license number line.) Bus.Tel. No.:47b 3605a3.:7
Address: q9 G.PSF 1•-ca rte, A- - AA - Alt.Tel. No.: �7f 34A6 T�7
*Security System Contractor License required for this work; if applicable,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.
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Date. . . !Z�45 (.. . .
NORTH
Of a••`o ,c,ti0
TOWN OF NORTH ANDOY
O � 9
• - PERMIT FOR GAS INST LLATION
SACMUSES
This certifies that . . .koqx. .1. 9!'�,'': . . . . . . . . . . . . . . . . . . . . . .
has permission for gas installation . . ./ !'0.9. . . . . . . . . . . . . . . . . . . .
in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . .
at . . . . . . . . . . . . . .
INorth Andover, Mass.
Fee.. D. Lic. No..0� .n . . . . . . �.l.,. .
GAS INSPECTOR
Check# 2-� L
5730
MASSACHUSETTS UNIFORM APPLICATON FOR PERM TO DO GAS FPITING
(Type or print) Date /s ,
NORTH ANDOVER,MASSACHUSETTS W
Building Locations "? / r �/` `V c®x`�, Permit# / 3V
$l / / Owner's Name Amount
New❑ Renovation ❑ Replacement � Plans Submitted ❑
rA
w
a U z
z
d
W WZ U a v Z
F z F W W W F W U QW'
Ww� > WWd F4 Y >+ v� z O z c4 ° vFi T
x O x D 3 q t7 a U a > A a
SUB -BASEMENT
BASEMENT
1ST. FLOOR
2ND . FLOOR
3RD . FLOOR
4TI-I . FLOOR
5TH . FLOOR
6TH . FLOOR
7TH . FLOOR
8TH . FLOOR
(Print or type 4 •
Name 'e2. mQ A N Check one: Certificate Installing Company
p 0�-^ � Corp.
Address /`f %1e__ Partner.
V'ej
BusinessTelephone Firm/Co.
Name of Licensed Plumber or Gas Fitter /,1V T:��7-9
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes 1:1 No❑.
If you have checked}_es, please indicate the type coverage by checking the appropriate box.
Liability insurance policy rl Other type of indemnity 13 Bond 1
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 Agent Owner 13 Agent 13
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 un- r Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State ,as Code a Chapter d42 of thetGeneral Laws.
By: Signature of Licensed Plumber Or Gas Fitter
Title Plumber
Cit /Town
Y as Fitter Mcens-e-INLIMMr
Master
APPROVED(OFFICE USE ONLY) .IOttrneyman
I
i
� i Ba StateGa
1y y s
A NiSource Company
May 24, 2006
Henry Licciardi Account Number: 5323520048
49 Fernwood St
North Andover MA 01845
Dear Henry Licciardi:
This follow-up letter is to inform you that your gas HAI located at 49 Femwood St has been tagged
due to a violation of state safety regulations. It is unsafe to use until the following condition has been
corrected.
Boiler under water flood, disconect and plug
The Masachusetts code pertaining to the installation of gas appliances and gas piping, established
under Chapter 737 Acts of 1960,requires that the condition be remedied.
If you have questions or would like to discuss this issue, please call 978-687-1105 and ask for the
Service supervisor.
Please disregard this notice if the condition has been corrected.
Sincerely,
Service or Meter Department
Bay State Gas Company
CRR: CRR#
CAdsupdatedletters\236 05/24/06
55 Marston Street P.O. Box 869 Lawrence, MA 01841-2312 978-687-1105 Fax: 978-688-1875
Date. .`. .C.�.... . .. .
NORTH
t Of
AWN OF NORTH ANDOVER
• . PERMIT FOR GAS INSTALLATION
y s s •
• 16N.
• a
h
SSACMUS't
This certifies that . . . ..w (? Y. .4.11. . . . . . . . . . . . . . . . . . . . . . . . .
t has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . . . . . . .
in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
at . . . . . .�. . !'. . . .. . `. . . . . . . . . . .L ., North Andover, Mass.
Fee. . . L. Lic. No.. . . . . . . . . . i� ..,...�... . . . . . . . . . . . . . . .
r�G INSPECTOR
Check#
5 5 'I 2
,%A,%ACUSEM LNVORM AP`PLICATON FOR PERM TO DO GAS F rMG
1Type or print) Date --2.d fl6
NORTH AN DOVER,MASSACHUSETTS
Building I ccations
`
`t 5 �/Lucay� Permit#
Amount S
Owner's Name -2t,���
New Renovation Replacement L Plans Submitted
C1 C1
Q ��"G >
m
� � V C0
t SUB -BASEM ENT
BASEM ENT
1ST. FLOOR
2ND . FLOOR
3RD . FLOOR
4TH . FLOOR
5TH . FLOOR
+ 6TH . FLOOR
7TH . FLOOR
8TH . FLOOR
(Print or type) / Chr4k one: Certificate Installing Company
Name 1, Corp.
Address 1o3 Partner.
Business Telephone D Firm/CO.
i
Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE- Check one•
I have a current liability Insurance policy or it's substantial equivalent. Yes M No
If you have checked Yes,please i 'cite the type coverage by checking the appropriate box.
Liability insurance policy Other type of indemnity Bond 1:1
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 Agent Owner ❑, Agent
`tcreby 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 ,.pork and installations performed under Permit Issued for this application will be in
_,cmPliance ,xith all pertinent provisions of the ''vlassachus gtts S tatoofia Ccde ► d apter 142 of the General Laws.
By:
gnature of Licensed Plumber Or Gas Fitter
Ti tic CR/Iplil 6 1c)
Cit,,Tcwn Cas Fitter icLse Number
Master
APPROVED Journeyman
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER,MASSACHUSETTS
Date
Building Location {,o�F1i lt.)QO112 Permit#
Amount
OwnerLlnlr(l
New Reno ation 0 Replacement Plans Submitted Yes 1-3 No 13
FIXTURES
SLSBM.
B441 INC
ISI:FLOOR
2nD FLOOR
3M FLOOR
4IH FLOOR
5IH FLOOR
6M FLOOR
71H FLOOR
8IH FLOOR
(Print or type) " ! Check one: Certificate
InstallingComa Name L�
p i� [. El Corp.
Address 0 1-3 Partner.
o (�
Business a ep one 60 Firm/Co.
Name of Licensed Plumber: 01 owl U
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy � Other type of indemnity D Bond
Insurance Waiver: 1,the undersigned,have been made aware that the licensee of this application does not have any one of the above
three insurance
ignature Owner Agent 1-3
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 ermit Issued for this application will be in
compliance with all pertinent provisions of the Massachusettstate P d Chapter 142 of the General Laws.
By: Signature orTicenseu riumiler
Type of Plumbing License
Title 0 ,,..�/
City/Town is se um er Master 1✓1 Journeyman D
APPROVED(OFFICE USE ONLY `.!