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HomeMy WebLinkAboutMiscellaneous - 62 OLYMPIC LANE 4/30/2018 (2) 62 OLYMPIC LANE 210/106.B-0112-0000.0 355 Date.................................. NOR7M °`<��'° :•'"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING SAC14US� F This certifies that .�� .................... has permission to perform........ ...................................................................... wiring in the building of........ ...................: .................................................... North Andover Mass. Fee./,. ........ Lic.No:� ,y...... `: o .r �:.�.................. p 'ELECTRICAL INSPECTOR Check #12/l0'6 The Commonwealth of Massachusetts FOR OFFICE USE ONLY Department of Public Safety Permit No. 8Receipt No. 0ARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 ' i 1APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work will be performed in accordance with the Massachusetts General Code.527 CMR 12:00 (PLEASE PRINT IN INK K OR TYPE ALL INFORMATION) Date l �� 6 Z City or Town of /UQ, � A Pn J o ff P_it To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below: Location(Street and Number) �N/i"t P f L w Map: Lot: Owner or Tenant 1 a +ol For- b7 es Zone: Owner's Address 5 az on °t-- Is this permit in conjunction with a building permit? Yes❑ No (Check Appropriate Box) Purpose of Building L)�`� �')1 I Utility Authorization No. 6 y`� 1j Existing Service Amps ZO l y� Volts Overhead❑ Underground©' No.of Meters�— New Service Amps / Volts Overhead❑ Underground❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work !ej C-5- 5 o G No.of,Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above grnd. ❑In-grnd.❑ Generators KVA No.of Receptacle Outlets No.of Oil Burners No.of Emerg.Lighting Battery Units No.of Switch Outlets No.of Gas Burners FIRE ALARMS No.of Zones No.of Ranges No.of Air Cond. Total Tons No.of Detection and i i itatn No.of Total Total Initiating Devices No.of Disposals Heat Pumps Tons KW No.of Dishwashers Space/Area Heating KW No.of Sounding Devices No.of Self-Contained IJo.of Dryers Heating Devices ' KW Detection/Sounding Devices No.of Water Heaters KW No.of Signs No.of Ballasts Local❑ Muncipal Connection❑ Other '4o.of Hydro Massage Tubs No.of Motors Total HP Low Voltage Wiring OTHER: INSURANCE COVERAGE:Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent.YES❑NO❑ I have submitted valid proof of same to this office.YES❑NO❑ If you have checked YES,please indicate the type of coverage by checking the appropriate box. INSURANCE❑ BOND❑OTHER❑(Please Specify) (Expiration Date) Estimated Value of Electrical Work$ Work to Start f����©Z Inspection Date Requested:Rough Final f 716 2 Signed under the enalti of perjury: FIRM NAME Elf 4�-tr 1`G G T,,,� LIC.NO. Licensee3 r!G yi �> t1 0:A Signature LIC NO. Address J0 Y`-. 17o1 VIN 2-c--S 1173 Bus.Tel.No. 9,700- 7-50_6 �'6!0 Alt.Tel.No. OWNER'S INSURANCE WAIVER:I am aware that the Licensee DOES NOT HAVE the insurance coverage or its substantial equivalent as required by Massachusetts General Laws,and that my signature on this permit application waives this requirement. Owner❑ Agent❑ (Please check one) J? Telephone No. PERMIT FEE$ (Signature of Owner or Agent) INSPECTION RECORD ` Date Notes — Remarks Inspector M •f 1 r 7 R � i Date. . ?..rvJ.. . . ...... .. { U NpRTH n TOWN OF NORTH ANDOVER 0 • . PERMIT FOR GAS INSTALLATION h �,SS�CMUSEI� n This certifies that . . . . . ... . . . . �. . . . . . . . . . . . . . hs permission for gas installation in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . at North Andover, Mass. Feen . .: . . . Lic: No— ?/.!,e. . . . /.-!1� r'�. . �... . . . . . . . . . . . GAS OR Check# 43 '11 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) Va. An c- - Mass. Date AlkrcPn 20_01__ Permit � Building Locatione'&oly wuptc-- Owners Name L'!4 --- 9,1r Type of Occupancy c�T New O Renovation ❑ Replacement I Plans Submitted: Yez O No p m v a W a M = C a y C tl! Q O W = yt W ft O V m r = 7f! i O tri ~ < a = o W O C W W W W p J Z < W C C Y W f t1 J W O Z W O p S C 'S O d S W 0 a a d v c Y a a. F� O sus—BSMT. BASEMENT ST FLOOR 2NO FLOOR SRO FLOOR 4TH FLOOR STH FLOOR ! 4TN FLOOR e 7TH FLOOR STH FLOOR Installing Company Name >A8Ac.aj4" s pl c�,b, Check one: Certificate Address 544 (Ze weist 51f . O Corporation :4P--_(Zp tat" (VIA . n n 1 S I O Partnership Business Telephone -r,,5t- a&,9- c�S--- t A FWWCo. Nage of Licensed Plumber or Gas Fitter ,-Y Q . INSURANCE COVERAGE: I have a urr liability insuranceYes No policy or its substantial equivalent which meets the requirements of MGL Ch. 142 If you have chedked yM please indicate the type coverage by checking the appropriate box A liability insurance policy Other type of indemnity O Bond O 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 perm application waives this requirement Check one: OwnerO Agent O Signature of Owner or Owner's Agent I hereby certiy 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 the permit issued for this application*ill be in compliance with all pertinent provisions of the Massachusetts State Cas Code and Chapter 142 of the General S. By TrUcense: G�6 Plumber re o Vicen3, umber a er Title Master license Number 1 31 CCD. City/Town Journeyman BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE - N0. APPLICATION FOR PERMIT TO DO G/.SFITTING NAME A TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIQ NO. PERMIT GRANTED DATE -20- .01 20- . GAS INSPECTOR