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Home My WebLink AboutMiscellaneous - 62 EMPIRE DRIVE 4/30/2018 �V ,.��/ - - - -- �- t. Date../7:...aG...... �Lr- t �aOR7q TOWN OF NORTH ANDOVER °L PERMIT FOR WIRING US This This certifies that ....... ...............1............... ........... has permission to perform ......... N ........ ................... wiring in the building of.........de:.X? ..K...................... A at...................l 4. n .,4P ,�.��.�...... . .c.... .. ......,North Andover.Mass. Fee..Y...:;�........ Lic.Not",Mr.......... ELECT UCAL INSPECTO• Check #lz 6 2— 10601 Commonwealth of MassachusettsEv.711/071 cial use only Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS e Checked APP'LICATIQN FOR PER blank IUltl' TO PERFORM ELECTRICAL 1tie1RK All work to be performed in accordannce with this M (PLEASE PR11V -JW NK•OR TYPE assachnsetts Electrical Code(MEQ,$27 CMR 12.00 City or Town of: NORTH NOVF .10M_ Date: - - BY this application the undersigned rues no a Ir�pector of.fires; Location(Street&Number) - °r her intention to the electrical work described below.. - - Owner or Tenant Z Owner's Address _ Telephone No. _ Is this penult in c0lIjtmctiOn with a ��g,b _ -- '. permit? � Purpose of Building i ' t t �'� No ❑ (Check Appropriate Boa _k Ms ) Service Anil 3 / Utility Authorization No. % 1a Overhead M Un�.d❑ No.of Meter, --- New---S=rvtce_ - ,-. Amps Z - - /z. c Volts Overhead❑ Uad d Number of F _ -_ - -•- 91;_—No. -_ . __ seders and. >�' of Meters ters Location and Nature of Proposed Electrical Work: - No.of Recessed Luminaires � letion o the ollowin 'table mbe waived b the I ector o wires -' Na.of CeiL-Susp.(paddle}Fans 0.0 • Pro.of Lw ainaire Ojttlets Transformers- - - otal _ lct¢<ref:tlot'�sAt:� - -• I�VA . vs�uiiliiYuiu'i:e. --.• —• - b+ mAuave w� mtng POOL d. ❑ 0.0 mergency —° No.of Receptacle Outlets . d. ❑ IIaits _ No.of Oil Burners - No.of Switches FIRE ALARMS No:of Zones No.of Gas Burners o.Of et on an N0-of Ranges - Initlatiri Devices . No.of Air Cond. --- o No.-Of - Tons No.of -. Waste Disposers t �i'�g Devices p _ er ons Totals: o.of on No,of Dishes De wed .. _ ashers -- teefaion/AIDevices., - ... Spaee(Area Heating XW Local unt. al No.of D _ ❑ �'� - Connection Other Heath � g APP�nces o.of sten_ _ _ KW 3eeurity ystems: Heaters KW 0.o _ a,of No.of Device;or E uivaIent - signs .o. Baffasta. Data No.Hydxomassa N ge Bathtubs - No.of Motors o.of Devices or E nfvalent t� OTHER- Total HP ecommunications R• No.of Devices or nfv ent - Estimated Value of Electrical Wozk: - �ittach additional detail ifdesired or as required b ' y the Inspector Work to S (Whet required b "sP 9}wires tatt: /'"/3/ rein' Y municipal policy) _. INSURANCE Inspections to be requested in accordance with MF.0 Rule 10,and on COVERAGE: Unless waived by the owner, na upon completion. _ the licensee rovides Permit for thePerformance -- .P roof of ' P liability insurance including°°� lid of electrical work may issue unless undersigned certifies that such coverage is' e operation coverage or its substan and tial e CIMM ONE: INSURANCE has exhibited proof of same to the equivalent The ❑ OTHER- (] (S permit issuing office. - I certify,under the pains-and penalties o er u pecitr) FIItM NAME: 1�P J lY,that the in.fornadon on this applicadon is true and complete. Licensee: A LIC.NO: ' a �-.�..- _ Signature �� f PPlicable, en r" pt• to the license manber line.) LTC.NO.• Address: _ Bus.TeL No.- 'Per M.G.L c . 147,s.57-61 ,sw �Y ark requires Alf»TeL No.: OWNERS INSURANCE WAIVER; �sriznent Public Safety"S°License: I am aware flint the Public does.not have the liabilitymac.No. required by law. By toy signature below,I hereby waive this a insurance coverage normally Owner/Agent requirement I am the(check one ❑owner ❑ Y Signature owners agent. Telephone No. P 3Z 4 ELECTRICAL PERMIT NO. INSPECTION REPORT: ELECTRICAL INSPECTOR.DOUG SMALL ' 1.ROUGH INSPECTION: _ Passed-fl5e Failed- [ l Re-inspection required($50.Q0)_[ � Inspectors'comments: (Inspectors'Signature-no initials) Date 2.FINAL IN PECTION: Passed Failed- ------------ [ I Re-inspection requfred($50.00)-[ j Inspector mments: (Ins ectors'S' nat e-n itials) j Date 3.UNDER GROUND INSPECTION: - - - ' Passed-[ J _ - Failed Re-inspection requ7ZO Inspectors'comments:(Inspectors'Signature-no initials) 4.INSPECTION-SERVICE: DATE CALLED NATIONAL GRID: - Passed-[ Failed-[ ] Re-inspection required($50.00)-[ Inspectors'comments: _ _ - ! {Ins ecto 'Signa re-no initials) _ Date S.INSPECTION-OTHER: 6 Passed-[ 1 Failed-[ ] Reins ection required($50.00)-[ ) Inspectors':comments:, }; (Inspectors'Signature-no initials) Date DOOR TAGS ARE TO BE FILLED OUT AND LEFT ON SITE IF THE AREA TO BE INSPECTED IS NOT _ _ ACCESSIBLE AND A RE-INSPECTION OF$50.00 IS TO BE CHARGED. 4' ' 9193 Date.11. 40RT" TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACMUS� This certifies that .�A>r,LM�.�L..�/ . 1�4.V 10 c G. . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . • • 4 plumbing in the buildings of . . D��.I��n�. �.a��t;¢z�,. . ti... t. . . . . . . at. . . L At'wt . . . . . . ./. . . .. North Andover, Mass. fes. • j Fee 512 Lic. No.(0�41.�. . PLUMBING INSPECTOR Check # 7� F .C—\ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY _VAOQ— tes MA. DATE 11—(6—V PERMIT# JOBSITEADDRESS Z C`Mpl � � OWNER'S NAME rD (Z V1I-LVr+Cff Lt c POWNER ADDRESS TEL FAX TYPE OR OCCUPANCY TYPE: COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL(� PRINT NEW: . RENOVATION:❑ REPLACEMENT: ❑ PLANS SUBMITTED: YES❑ NO ❑ CLEARLY FIXTURES Z FLOOR— BSMT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB L CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYS DEDICATED GAS/OIUSAND SYS DEDICATED GREASE SYS DEDICATD GRAY WATER SYS DEDICATED WATER RECYCLE SYS DRINKING FOUNTAIN DISHWASHER FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY 3 ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET I Z URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which,meets the requirements of MGL Ch.142. Yes&No❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW 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 Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE BOX ONLY: OWNER E] AGENT ❑ Signature of Owner or.Owner's Agent 1 hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Ch ter 142 of the Gener I Laws. PLUMBER NAME STEP111510 C. GALIr.3SKY SIGNATURE LIC# 1034 S MP[' JP❑ CORPORATION X# 319 b PARTNERSHIP ❑# LLC ❑# COMPANYNAME GAuNsKY PLUM OJAJ 61VAT &j ADDRESS: P.D. Gox 1701 CITY HAVERFt1LL STATE M-A- ZIP 01131 EMAILy ww. imrplunnberjWl . cowl TEL ()'7V-3,7N- 17jj3 CELL 50-50411-.5g0N FAX q7$-$6ZI-+f13i I ROUGH PLUMBING INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES r Date... a ,aORTH pE ��ao ,•,tip - o� ` °p TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION a SAOHUSES }} 1 This certifies that . . .C?!'�.!'`-v.�'. . . . . . . . . . . . . . . . . . . . . . . . i has permission for gas installation . . . . . . . . . . . . J { in the buildings of . . C?(?�.H^n�o v ►-�!�?c . ,4c-c. . , . . , , . z at �5!'✓.!,P!Yl.-up� . . . , North dover,paasss. Fee' ,l O 6 (2 / y 7'1 4Q�:coo. Lic. No. Y. . . l� GAS INSPECTOR Check# �V"7 -7 7905 { MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY: N.OMA "WQ&k MA. DATE: 11-4-11 PERMIT# JOBSITEADDRESS:Z C.01 DI&, _ OWNER'SNAME: &V,(A•b" Q%LL(KEAC GOWNER ADDRESS: TEL: FAX: TYPE OR OCCUPANCY TYPE: COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAIn PRINT Y'--� CLEARLY NEW: RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ APPLIANCES? FLOOR 13smt 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT NEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCK MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT i TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER INSURANCE COVERAGE I have a current liabil" insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES NO ❑ If you have checked YES,please indicate the type of coverage by checking the appropriate box below. LIABILITY INSURANCE POLICY 9 OTHER TYPE INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application wil be in complian a with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBERIGASFITTER NAME: STEPHEN C. GAL r N S KY LICENSE# 10 3 q Zi�SIGNATURE COMPANYNAME: GAL413K`d PLII AAWC + kr-r4fifr & ADDRESS: P.0- Nox 1701 CITY:— s4 AV ERH I LL, STATE: 1'n-A ZIP: O I S 31 FAX: 1479- 6al-4131 TEL: 979-3714- 17,43 CELL: 5,04- 6tA- 5g0+1 EMAIL: W VV W. mrpl u-►befC4lb MASTER V JOURNEYMAN❑ P I STALLER❑ CORPORATION[�# 31�!� PARTNERSHIP❑# LLC r-]# ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES