HomeMy WebLinkAboutMiscellaneous - 70 SUTTON STREET 4/30/2018m
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Date .... r- -3n -66
....................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ............I V. A 4......... .......................
has permission to perform .... rA 0. 0. a ...... ...........................
wiring in the building of ..... M ........... ...............................
at ..........4..5r.... . . ................... . NorthAndover, Mass.
Fee
.... Lic. No.�FA5 4........................t .
ELECTRIC AL
INSPECTOR
Check #
671j2
0
` \ Me Use Pn�
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G, ht LfII1ItiI uiurafth If 5n,5#1m2tt5 Permit No.
Mt;mr mint of ITubliL 262fEttj Occupancy & Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 VJR 12:00 (leave blank)
APPLICATION FOR PERMIT TO PERFORM- ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Cade, 527 CMR 12:704_
(PLEASE PRINT IN INK 0 PE ALL INFORMATION) Date �
(XX or Town of ►V oy arrnwFR To the Inspect r of Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street 3 Number)✓�,pu,�ry
Owner or Tenant ±m `ea
Owner's Address
Is this permit in conjunction with a buil 'ng p rmit: Yes _ No _ (Check Appropriate Box)
Purccse of Suiidirla ` ` t Utility Authcrization No.
Existing SerAce Amps _J_x/tits Overneae _ Unegrnc [ No. of Meters
New Semite Amps Vclts Overreae _ UncgrnC _ No. of Meters
Numcer of F=eters ant Am.cac:ty
Lccancn ar.c Nature ct Prcccsec EEec-ncai %Vcrx (ase � rJ�.hit '7 601//&K Ov�
n;0� 0VTT�
No. at _:,^ung ;octets
No C ..=s I No. ct transformers 1o}(tVA
No. at L.gnting 7- xtures
No. ::t =ecectac:e Cutlets
No. of Swrtc^ outlets
No. of Ranges
No. at Oisccsats
i ACove.— ;n-
Swimming ?Col grna. _ cncc. _
No. of Cil 6urners
No. ar Gas=L•rners
No. o! Air ClocalCrc. tons
!eat Total Total
No.cf PunnCs Tone KV4
i
No. at Cisnwasners - ScaceiArea Heating K1V
No. of Crrers ! Heauna Cev:ces KW
No. at No. at
No. of '.Vater Heaters i Signs Sadasts
�! No. �m!vcro Massage ups No. of %iotcrs Tatai HP
C7 'HEP:
t
Generators KVA
I Na. It =mergency LiCnttng
3arery Units
FIRE ALARMS No. of =Cnes
No. of Cetecnon anc
Initiating Cevtces
No. of SCuncing Cevtces
No. at Self Container
Oetec::onrSounetng Cevtces
Local - Muntcical Other
Connec-.:on
Law voltage
Wir:nc
INSURANCE =JE=AGE: Pursuant :o the reeutrements at .'.lassaCnt;SerS ;enerat 'Laws _
I
1 have a current Llaeciity Insurance PCItC'J rnc:uctng Cem..c:etec Oceraticns Coverage or ;is suostantial ecuivalent. YES _ NO
nave suemlttee valid Croat ct same to the Office. VES = NO _ It you nave cnecxee `!ES. Ctease ifolcate Tie type " t ao erage Cy
cnecxtng :Me acor mate Cox. �,eQa�,eS 1/!'S %Z 3 !�
INSURANCE 3CNC = CTI-7ER �se SceF:l/I (Ex ratio atei
Esamatee Value of E'.eetneai 'Norte 5 r,nal
Wcrx :a Star. Inscect:cn Cate �acues:ec: Rough
SS(;nea cancer the Penalties of perlury:j S
FiRb1 NAME /64110UC. NO.
S�/ 1✓�/� STP Sig,acure Ll N/O. QST
Licensee
'F� Sus. :eN
. o.
Acdress �.G�/ (/��alt.:ei. No.
OWNERS INSURANCE'WA1VEF: I am aware tnat the Licensee Coes r.ot nave the insurance coverage or Its suostanttal eaulvalenAt ante
Cutrea ov Massachusetts General Laws. anc trial my signature on :n:s perms aoolicatton waives this reeutrement. Cwner 9
IPlease cnecx one)
–e+ecncne No. PERMIT FEE S
iSignacure ct Cwner Cr Agentt
340/ Date. `��.......E.......
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that ....................
has permission for gas/installation .... P .�f ............
in the buildings of ......................
at .... ! .. s . t- ... <. .. /._, North -Andover, Mass.
r
Fee...f .s .:: Lic. No...//W.,(< ... .... ,�.�:. . .
I6AS INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
ti
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type) r f
Massachusetts Date 'I -1k ?90d Permit # -[ O
rmit Fee
Building Location 7/.) syZ7�ih0 S) Owner's 2tcuoZ-pancy
�Aj
Gf
Type of
012
New Renovation Replace ent >< ;Plans Submitted: Yes[] No K
Installing Company—Name f��/h. / Check one: Certificate
AddressSS I ] Corporation
!� v[4 -Partnership
Business Telephone2�-2 �s�5 -/221 1 1 Fir . /Co.
Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE:
I have a current Il9Llltty insurnce policy or its substantial equivalent which meets the requirements of MGL Ch. 142,
Yes No 11
If you have checked yes. please/Indicate the type coverage by checking the appropriate box.
A liability Insurance policy I[X Other type of Indemnity I l Bond L1
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 i Agent []
Signature of Owner or Owner s Agent --
I hereby certify that all of the details and infofrnation 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 pertormed under the permit Issu d for this application will be in comp iance it
pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the G al Law
License'
F lumber
g alure o Licensed tum r or filter
Tills _ Gasfitler `
aster License Number ` -
Cit /Town Journeyman -.-
u�favE6-ta�rr�t--o��1 � ------
Inspection Date Requested
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SUB-BSMT.
BASEMENT
'
IST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
STH FLOOR
7TH FLOOR
8TH FLOOR
Installing Company—Name f��/h. / Check one: Certificate
AddressSS I ] Corporation
!� v[4 -Partnership
Business Telephone2�-2 �s�5 -/221 1 1 Fir . /Co.
Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE:
I have a current Il9Llltty insurnce policy or its substantial equivalent which meets the requirements of MGL Ch. 142,
Yes No 11
If you have checked yes. please/Indicate the type coverage by checking the appropriate box.
A liability Insurance policy I[X Other type of Indemnity I l Bond L1
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 i Agent []
Signature of Owner or Owner s Agent --
I hereby certify that all of the details and infofrnation 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 pertormed under the permit Issu d for this application will be in comp iance it
pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the G al Law
License'
F lumber
g alure o Licensed tum r or filter
Tills _ Gasfitler `
aster License Number ` -
Cit /Town Journeyman -.-
u�favE6-ta�rr�t--o��1 � ------
Inspection Date Requested
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