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Date.............................
TOWN OF NORTH ANDOVER
9
PERMIT FOR WIRING
L�b t ve" -r Se. -rte 5
Thiscertifies that ...........................................................................................
has permission to perform .............................................................................
wiring in'the building of ....V.0 �yJ��F.....rG,,., ...
G?yld
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at ........................! ,�. C..............v! .........PLEC�TiICAL
.,North Andover, Mass.
Fee . SS �=.... Lic. No.%. l b�i�
.—R.... .......
INSPECTM
Check #
Commonwealth of Mad6aehaeeffd Official Use OnlyED Z j
V IBM -
eLJe ariment o }ire �erviced Permit No. /
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Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leaveblank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 521 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: July 15, 2010
City or Town of: _N ° Audover 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) 52 Village Green Drive Building M
Owner or Tenant Village Green Condos
Owner's Address
683-4101
Telephone No.
Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box)
Purpose of Building Commercial Utility Authorization No.�C9
Ex;sts^.g serv.ce Am Is i Volts
New Service Amps / Volts
Number of Feeders and Ampacity
Overl;cvd ❑ Undgrd ❑ No. of Meters
Overhead ❑ Undgrd ❑ No. of Meters
Location and Nature of Proposed Electrical Work: Meter socket replacement
Completion of the following table may be 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
No. of Luminaires
Above In-
Swimming Pool rnd. ❑ arnd. ❑
o. o mergency Lighting
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. Detection and
Initiating Devices
No. of Ranges
g
No. of Air Cond. Total
Tons
No. of Alerting Devices
Heat Pump
Number
Tons
KW
No. of Self -Contained
No. of Waste Disposers
p
Totals:
. ..
..
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local 0 Municipal ❑Other
Connection
No. of Dryers
Heating Appliances KW
Security tio. Devi es or Equivalent
No. of Water KW
No. of No. of
Data Wiring:
Heaters
Signs Ballasts
No.�of Devices or E uivalent
No. Hydromassage Bathtubs
No. of Motors Total HP:
Telecommunications Wiring:No. of Devices or E'qujvalc^t
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: 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 coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE KI BOND ❑ OTHER ❑ (Specify:)
I certify, under the pains and penalties of perjury, that the information on this application is true and complete.
FIRM NAM' E: Crowe & Sons Electrical Cor# LIC. No.: 1-ki68A
C
B
James B. Crowe Licensee: JSignature LIC. NO.•���—�4453--6696
(If applicable, enter "exempt" in the license number line.) $us. Tel. No.: �° /
Address: 576 Middlesex Street, Lowell,I Mn 01852 Alt.Tel.No.: -6696
*Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. LIS CO 001051
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
Signature Telephone No. PERMIT FEE: S 55,00
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Date.
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TOWN OF NORT,A ANDOVER
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PERMIT FOR PLUMBING
This certifies that ....%!fir l/ll.�i / ...�t�trlrt"�. ............
has permission to perform . �! . f/ fly�...,,.���.. f.��1�� u,,,,
plumbing in the buildings of..V��vir!�
at ... 5�%.. j..3North Andover, Mass.
Fee�� 5•.�C�Lic. No..%%11.�f . .... � a.'�A,��;!�c;L;�'., ... .
PLUMBING INSPECTOR
Check #
7832
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
rt" Date
Building Location .5 I ,`i .3 S" 6, S � Owners Name V l lkQ (if-, COCA&j permit #
v i fqc6e— css-oL" 6 rtvc Amount
Type of Occupancy
Cs�UJ
New Renovation Replacement '� Plans Submitted YesNo
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(Print or type)
Installing Company Name k3 r) w 0•°4S(T\
Address 5S �Or-- V \�\\\ N%,
usmess
Check one: Certificate
11 Corp.
❑ Partner.
® Firm/Co.
Name of Licensed Plumber:
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy 0 Other type .of indemnity ❑ Bond
F
Insurance Waiver. I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature IOwner ❑ 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 Massachtsetts State Plumbing Code and Chapter 142 of the General Laws.
y:
City/Town
APPROVED (OFFICE USE ONLY
Type of Plumbing License
\l0y\
License Mmoer Master zi Journeyman ❑
Date.. �./�/G...... .
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TOWN OF NORTH ANDOVER
A
PERMIT FOR GAS INSTALLATION
•SgACHUSE`
This certifies that . �%? �.1iQ/!� (..... �UM r PI
has permission for gas installation . j%... �.. ........
in the buildings of . � -"" .. 1/ ! tai C?.. j fpr+ .. /�.. <I, Z_
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at �.,. �.. ?..r. �� !. ........ North Andover. Mass.
Fee %n, 11. (iQ Lic. No. l � ..`..... /. °*,r!�'!4 - .. /'. . .
GASINSPECTOR
Check # /, J
6525
MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING
(Type or print) Date I
NORTH ANDOVER, MASSACHUSETTS v0
Building Locations gl, 5� 3 5, S-7. \/ Mclac �� ���. �
Permit # _
Amount
Owner's Name
New D Renovation Replacement ® Plans Submitted
C6�
SU B-BASEM ENT
BASEM ENT
IST.
FLOOR
2ND.
FLOOR
3RD.
FLOOR
4TH.
FLOOR
5TH.
FLOOR
6TH.
FLOOR
7TH.
FLOOR
8TH.
FLOOR
(Print or
Name_
Address
usmess
Name of Licensed Plumber'or Gas Fitter
Checkone: Certificate Installing Company
0.Corp.
Partner.
® Firm/Co.
INSURANCE COVERAGE
I have a current liability Insurance, policy or it's substantial equivalent. Yes c�
If you have checked yes, please indicate the type coverage by checking the appropriate box. No�
Liability insurance polic
Y � Other type of indemnity D Bond 13
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.
Signature of Owner or Owner's Agent Check one:
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 under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachuse State Gas Code and Chapter 142 of the General Laws.
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IBy:
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(APPROVED (OFFICE USE ONLY)
Signafu* of Licensed Plumber Or Gas Fitter
Plumber ', � 1
Gas Fitter License Number
® Master
Journeyman
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Name of Licensed Plumber'or Gas Fitter
Checkone: Certificate Installing Company
0.Corp.
Partner.
® Firm/Co.
INSURANCE COVERAGE
I have a current liability Insurance, policy or it's substantial equivalent. Yes c�
If you have checked yes, please indicate the type coverage by checking the appropriate box. No�
Liability insurance polic
Y � Other type of indemnity D Bond 13
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.
Signature of Owner or Owner's Agent Check one:
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 under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachuse State Gas Code and Chapter 142 of the General Laws.
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IBy:
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(APPROVED (OFFICE USE ONLY)
Signafu* of Licensed Plumber Or Gas Fitter
Plumber ', � 1
Gas Fitter License Number
® Master
Journeyman
Date.. —T, -.��Y
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that ............ • •
has permission to perform ....... =::^ '...� ............... .
plumbing in the buildings of .•� �2................
�J........ North Andover, Mass.
Fee.,: } ; ..... Lic. No. ! -`. ` ..7_�-r't............ .
%'' _ PLUMBING ' ii
/ 1077�� INSPECTOR
Check #
53G9
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print
/or Type)
/ If � •1� , Mass. Date ZDo 2 Permit # L
c y�
Building Location P� � anwner's Name&
Type of Occupancy' 4iC5► DEN Ti AL_
IV
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New ❑ Renovation ❑ Replacement IId' Plans Submitted: Yes ❑ No ❑
FIXTURES
Installing. Company Name 20t3i:eT Q • !SAer m 4 TAP_? Check one: Certificate
Address �% n Cr; �q c N m4 t j � ❑ Corporation
/Y) E % N o /1 . Yo A U 1Ntl ❑ Partnership
Business Telephone �Iff Z -5177 1 � /Co.
Name of Licensed Plumber 'r5 f; r3, ie 7- 41-
INSURANCE
1
INSURANCE COVERAGE:
I have a currentflability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes No ❑ '
If you have checkedrtes, please
/indicate the type coverage by checking the appropriate box.
A liability insurance policy Ad 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:
Owner ❑ Agent ❑
I hereby certify that all of the details and information 1 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 the permit issu for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plum 'ng a and Cbapter of the eral Laws.
By. L
Title Yxdbre of Licensed Plumber
Type of License: Master Journeym; lh ❑
City/Town -
APPROVED OFFICE US ONLY) License Number_ 5
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BASEMENT
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3RD FLOOR
4TH FLOOR
5TH FLOOR
6TH FLOOR
7TH FLOOR
STH FLOOR
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Installing. Company Name 20t3i:eT Q • !SAer m 4 TAP_? Check one: Certificate
Address �% n Cr; �q c N m4 t j � ❑ Corporation
/Y) E % N o /1 . Yo A U 1Ntl ❑ Partnership
Business Telephone �Iff Z -5177 1 � /Co.
Name of Licensed Plumber 'r5 f; r3, ie 7- 41-
INSURANCE
1
INSURANCE COVERAGE:
I have a currentflability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes No ❑ '
If you have checkedrtes, please
/indicate the type coverage by checking the appropriate box.
A liability insurance policy Ad 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:
Owner ❑ Agent ❑
I hereby certify that all of the details and information 1 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 the permit issu for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plum 'ng a and Cbapter of the eral Laws.
By. L
Title Yxdbre of Licensed Plumber
Type of License: Master Journeym; lh ❑
City/Town -
APPROVED OFFICE US ONLY) License Number_ 5
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