The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 700 GREAT POND ROAD 4/30/2018 (2)MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING t (Print or Type) <N NORTH ANDOVER Mass. % Date r �uilding Location p �e �i�/ 1, Permit # Z 6 0 • Owners Name • �` New renovation Replacement Plans Submitted D FIXTUP=S (Print or Type) ) Check one: Certificate Installing Company Name V-' _ e ( �] Corp. Address Partner. ts37 g E-Firm/Co. Business Telephone: Name of Licensed Plumber or Gas Fitter Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner F] Agent M 1 hereby certify that all of the devils 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 perforated under' Permit issLed for this application w' to comp ' oe with all perQ provisions of the bfassachusettt Slate Gas lade and Chapter 142 of the General I.Awa. By TYPE LICENSE: lumber Title Gasfitter igna a of Licensed City/Town: Master Plumber or Gasfitter Journeyman �� V APPROVED (OFFICE USE ONLY) LiCfenserl Dumber J V • = rrrrrrrrrrr�r■■ ■rrrrrrrrrr rrrrrrrrrrrrrrrrrrrrrrrrrr .. ■rrrrrrrrrrrrrrrrr`3rrrrrrr . ... rrrrrrrrrrrrrrrnrrrrrrrrr .. .. _ rrrrrrrrrrrrrrrrrrrrrrrrrr� .. - ■rrrrrrrrrrrrrrrrrrrrrrrr■ .. - ■rrrrrrrrrrrrrrrrrrrrrrrr■ . • • - rrrrrrrrrrrrrrrrrrrrrrNONE ... ■rrrrrrrrrrrrrrrrrrrrrrrrr .. _ ■rrrrrrrrrrrrrrrrrrrrrrrr■ (Print or Type) ) Check one: Certificate Installing Company Name V-' _ e ( �] Corp. Address Partner. ts37 g E-Firm/Co. Business Telephone: Name of Licensed Plumber or Gas Fitter Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner F] Agent M 1 hereby certify that all of the devils 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 perforated under' Permit issLed for this application w' to comp ' oe with all perQ provisions of the bfassachusettt Slate Gas lade and Chapter 142 of the General I.Awa. By TYPE LICENSE: lumber Title Gasfitter igna a of Licensed City/Town: Master Plumber or Gasfitter Journeyman �� V APPROVED (OFFICE USE ONLY) LiCfenserl Dumber X607 a NORTH TOWN OF NORTH ANDOVER CL pF teo ,tip 3? p " PERMIT FOR GAS INSTALLATION3 ,. A' pp ~ p V7 sse ^+ CU This certifies that .. DW-." .... F! .f..............�. has permission for gas installation ..� ...�.r/��.. 0 in the buildings of .1: 4 /.,Ys. ............................... . at ..' 1? c & { ...i ?p . ` . .. ! <<PASINSPECTOR Andover, Mass. Fee.. ? U•.�. Lic. No. "l. WHITE: Applicant CANARY: Building DK: Treasurer Wee Use Only /�l o� ; f lommeawful� of massae >:� Permit No.. 6 V 1 VeMifta t of Public; Oddi Occupancy & Pee Checked 3M (leave blank) BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 !'}r;A OPLUC"AT"iN FOR, PERMIT TO PERFORM ELECTRICAL WORK AYL ll work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 1:00 p E l! (�i.�A E 'RiNT IIV INK OR TYPE ALL INFORMATION)oats 4 _ C9 itirf 'D�ii/ or 1b nANDOVER To the Inspector of Wires: On* pp . the udOm ntld applies for a permit to perform the electrical wor describ d bolo 7 41 Lftktion'•(8tr� t & Number) �� b &rfo'r or teriant i C� Iii I'll this permit in conjunction with building I si g perm,t: Yes ❑ No ❑ (Check Appropriate Box 1 r=� Purpost.of wilding Utility Authorization Na `� �X 0ng S'trVlc9: AmpsVolts Overhead C3Undgrnd l No. of Meters Nbvv_Service ' Amps �I Volts Overhead ❑ Undgrnd ❑ No. of Meters I;= MNumbs► of Feeders and Ampacity Ldcatioh and Nature of Proposed Etettrical Work t Y`` U �T7 d� F Nd of LlpMtng Outlets' '.' No. of Hot Tubs No. of *ansformers Total KVA fVo of Uphtit taxturb's Swimming Pool Above In- ❑ ❑ gmd. gmd. Generators KVA Iib. of Aece d` pEi�cle Outlets , No. of Oil Burners No. of Emergency Lighting Battery Units Ilio of $wltth Gallate No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Nb of fangee ' No. of Air Cond. Total s tons Initiating Devices No of 131sp osa: Is No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Local Municipal ❑ Connection ❑Other -' No. of titahwashttirs .. Space/Area Heating KW No. b of Dr�srs Heating Devices KW flo. bf WateF Wsatere " KW No. of No. of Signa Ballasts Low Voltage wiring No Nytl� Mtyssiee Bibs No. of Motors total HP INSURANCE COVERAGE: Pursuant to the requirement's of Massachusetts general Laws I haus a current Uabllity Insurance Policy including Completed Operations Coverage or Its substantial equivalent. YES - NO = I hairs submittbd.velid proof of same to the,.Office. YES W --NO C If you have checked YES, please Indicate the pe age by �r checking the appropriate box. INSURANCE A BOND C OTW]af G (Please Specify) Expiration Date) �aereate i VWU6 of Electrical Work S -Worn to Start - Inspection Oats Requested: Rough — Final Silgftsd under the ndltlea of per M NAMO LIC. NO. rUL`enssb �' V S SignatureLIC. NO. - a Bus. 1b1. No. c>E ev3 C, 3 Alt. Tel. No. * bVVkew,g INSUIPIANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or Its substantial equivalent as re- -o n , qulred ay Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (PtSon check one) /• - Telephone No. PERMIT PEE S 2j I (Signature of Owner or Agent) x-6565 ' Date. .... 31, /�:% 1626 NORTH TOWN OF NORTH ANDOVER 3 C c , Y PERMIT FOR WIRING. �f SACMUSfct This certifies that..........�Yi. �.�: .. 4....... .... has permission to perform...+�: ....... k.. . wiring in the building of ............ .... ......�d...�'fL..., s at ..... 7do .....C^.tq ....(v`? '. 4t' North Andover, Mass Fee ....Lic. No., ......:.. ELECTRICAL INSPECTOR y, Clk 1# 03306 /30/97 11:54 75.=04 ...SID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer N