HomeMy WebLinkAboutMiscellaneous - 495 JOHNSON STREET 4/30/2018 495 JOHNSON STREET
210/098.A-0017-0000.0
3 5 _ Date. L/ s..:. .'5 ......
"ORTi, TOWN OF NORTH ANDOVER
pf 4��ao ,e 1.4p i
or ., °� PERMIT FOR GAS INSTALLATION
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SACHUSEt d
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This certifies thatac..1. • • • • � • `. • • • • • • •�2-
has permission for gas installation . . .f:/'"'• •16•'4-:<r. .
in the buildings of . . , i �.,�. . •6 � � ��•'�f. . . . . . . . . . . . • • •
at . .Ll ?S . . r•:1�: '�. :, North Andover, M*.
Fee. Lic. No..b.s.F/2. a;.... .. . ... 10
GGAS INSPECTOR
WHITE:Applicant CANARY:Building Dept. PINK:Treasurer c
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MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING
ype or print) Date -4 - 6 19��
NORTH ANDOVER, MASSACHUSETTS
Building Locations *q5 J^a h lI /1 L-� Permit# 31J- 2-
A/ Amount�
No 14 n do U -er rn Q • Owner's Name P4Q/ MU I-re y �
New❑ Renovation ❑ Replacement Plans Submitted ❑
V1 C ryj
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W a Z C Z
rn Cn L W n Z :0
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SUB -BASEM ENT
BASEM ENT
IST. FLOOR
2ND . FLOOR
3RD . FLOOR
4TH . FLOOR
5 T H . F L O O R
6TII . FLOOR
7T11 . FLOG R
8T H . F L O O R
(Print or type) /7,,/ f / Check one: Certificate Installing Company
Name f�l� hIle goc/ /�IGd/ &MI at// 4lf; Corp. I60QG
Address Aox 7.228 ❑ Partner.
A/0. 11&011fr, 2M %?-
Business Telephone 9.78 9. 75 ¢ZV ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter P-ab erl-
INSURANCE COVERAGE _ Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes MM No❑
If you have checked Yes,please indicate the type coverage by checking the appropriate box.
Liability insurance policy Other type of indemnity ❑ Bond ❑
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 ❑
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 Massachus tts State Gas Code and Chapter 142,4f the G neral Laws.
By: Signature of Licensed Plumber Or Gas Fitter
Title ❑ Plumber . g 597
City/Town ❑ Gas Fitter License t umoer
❑ Master
APPROVED(OFFICE USE ONLY) ❑ Journeyman
N° J7
Date...lam....-:...:.-..%°..........
Cf NORTN
TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
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,SSAc"US� _f
This certifies that-. `............ ..C' r ✓......................................
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permission to perform'.:.../�' - ..:�.-t'.-- -. , ..._......................
ing in the building of ......... �'Y �.:.! �,Y ......................
..... �. .. :!. �:.. ... j�.t�'...... ,Nbtth Andover,Mass.
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..... Lic.No` .cFtr.
Fee:...!:�........ (f,..�.............................................................
` ELECTRIC AL INSPECTOR
69/29/98 14:32 35.CitID
WHITE:Applicant CANARY: Building Dep. PINK:Treasurer
Office Use Cnly
Permit No_ 7
Dc r-.o.c 4;P_d e S.E.4 Occupanc/&Fee Ched ed
- BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
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) Date
To the In pector of Wires:
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below.. T
I.acation(Street&Number��
Owner or Tenant
Owner's Address l 'S T
Is this permit in conjunction with a building permit Yes ❑ No (Check Appropriate Boz)
Purpose of Building
Utility Authorization No.
Eldsdng Service_ v Amps �d/� Vcib Overhead� Undgmd ❑ No.of Meters
New Service Amps /Oats Overhead ❑ Undgmd ❑ No.of Meters
Number of Feeders and Ampacly
Location and Nature of Proposed E!e=cal WorkL-'/2XZI-ZFZ 01,
Total
No.of LightOng Outlets No.of Hot fuse i No.of Transformers KVA
Above ❑ In C
No.of lighting Fixtures ( Swimminc Pool qmd C gma C Generators KVA
No.of Emergency Lighting
No.of Receptacles Outlets No.of Oil Sumers Sattery Units
No.of Svntc^i Outlets No of Gas Burners FIRE ALARMS No.of Zone
Total No. Detection and
No.of Ra}ldes No of Air Cand Tons Initiating Devices
Heat Total Total I
No.of QSoosal No. Pumps Tons KW No.of Sounding Devices
No./of Self Contained
No.of 0 srwasners I Soace/Area Heating KW DetecsorvSounding Devices
C Municipal C Other
No.of Dryers Heating Devices KW Local Connection
No.of No.of Low Voltage
No.of water Heaters KW Signs Bailases Winn
No HWro Massage Tuds No of Motors Total HP
OTHER:
INSURANCE COVERAGE. Pursuant to the regwremen6ts of Massachusetts General Laws
I have a current Llabdity Insurance Polic/including Completed Operations Coverage or its substantial equivalent YES= NO =
ha'. subaa Ed valid proof of same to the Office YES= NO �qu have checked YES please indicate the type of caves a by checking the appropriate box
Imo_ C_A - 80ND = OTHER = (Please SpeGfy)�
�yvry (Expiration D e)
Estlma lue of Electrical Work$ n �
Work to .I Inspect Date Resquested ly1 ./� Rough Final
Signed urr the Penattfes of per)ury: Ll
FIRM NAM UC.NO.LE�/7
; >P �/ �(
Llcanaee f�'�4=�f� // —�G/ � LIC.NO./. Signature // C
Bus.Tel No.
Address _ O< t(irr/'/r
Aft Tel.No.
OWNER'S INSURANCE WAIVER: I am aware at the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws.And that my signature on thi permit appileatfon waives this requirement. Owner Agent (Please Check one)
Telephone No. PERMIT FEE 5�—
(Signature of Owner or Agent)