HomeMy WebLinkAboutMiscellaneous - 75 FOSTER STREET 4/30/2018 (2)E.
Date .....
TOWN OF NORTH ANDOVEW
PERMIT -FOR WIRING
This certifies that ............. -j ...... /,.E.0/V?M 6 .............................
.......... ..... ..... .........
has permission to perform ......9 .....6;:.-........... 47-.�.........................
wiring in the building of ............... /�.*. /. lu ...........................................
at ..... . . ........... ........ North Andover Mass.
Fee..) ............ LiC. N .............. ......... .......
ELECTRICAL INSPHTOR
Check #
10402
;❑ 2012 Massachusetts EIectrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance -with the provisions of M.G.L. c. 143, §, 3L, the
ennit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed -
on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M G.L c. 166, § 32, an
electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the
notification of completion of the work as required in NLG L. c. 143, § 3L.
Permits shallbe limited as to the dime, of -ongoing construction. activity, and maybe deemed_by the.Inspectorof--Wires abandoned.and-invalid.if-he—:
or she has determined that the authorized work has not commenced or has not progressed durng'the prtceding 12 month period. Upon written
application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written
request of either the owner or the installing entity stated on the. permit application.
❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of
the Acts of 2012. The purpose of this act is to promote job;growth and long-term economic recovery and the Permit Extension Act furthers this
purpose by establishing an automatic four-year extension to certain -permits and licenses concerning the use or development ofreal property. With
limited exceptions, the Act automatically dxtends, for four years beyond its otherwis a applicable expiration date, any permit or approval that was
"in effect or existence" during the qualifying period beginning on August 15, 2008_and extending trough August 15, 2012.
ule—Permit/Date Closed: I Z —/ % G. Note: Reapply for new perm
❑ Permit Extension Act — Permit/Date Closed:
Commo►uu¢alth o�a�achubettd Official UseOnly
16 0cc�� Permit No. ' % 2-
Acc77rartment o/ ire �ervice!
Occupancy and Fee Checked
- U70 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMAT A9 Date:
.City or Town of:A n V �i� To theInspe rc o of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number)
Owner or Tenant
Owner's Address
Telephone No.
Is this permit in conjunct io with a bu'lding permit? Yes E] No [:](Check Appropriate Box)
Purpose of Building 12p&, to Utility Authorization No.
r
Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and ;4at re of Proposed Electrical Work: 22,
Completion of the followingtable 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
AboveIn-
Swimming Pool rnd. ❑ rnd.
❑
o. o Emergency Lighting
Battea Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
I No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Initiating Devices
No. of Ranges
. of Air Cond. Tota 2^/L
No. of Alerting Devices
No. of Waste Disposers
p
Heat Pump
Totals:
Num er
Tons
KW
.........
No. of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Municipal ❑ Omer
Connection
No. of Dryers
Heating Appliances KW
Secu oDevicesmf or Equivalent
No. -of Water Kms,
Heaters
No. of No. of
Signs Ballasts
Data Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications Wiring: .
No. of Devices or Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated ValueRf-Electrical Work: IU (When required by municipal policy.)
Work to Start: (� Wa 42 1 cor 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 co erage is in force, and has exhibited proof of same to the perm t issuingoffice.
CHECK ONE: INSURANCE OND ❑ OTHER ❑ (Specify:) /" l CTadP2oZ
(/%rG� C -e
I certify, under thepainsa nd enalties ofperjury, that the information on this pplicatioelete.,_
FIRM NAME: IA Cf(r' LIC. NO.:OL
Licensee: Signatur LIC. NO.:
(If applicable, ent r "exempt" i the license nu ber line.) h �G / L Bus. Tel. No.:
Address: �v/ Alt. Tel. No.:
*Per M.G.L. L 11r, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normall
required by law. By my signature below, I hereby waive this requirement. I am the (check one)❑ owner ❑ owner's a ent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $
AYr
Ottice Use Only •�
t `7L LIIYIIIItDII11IEIIif�I of �Sc�IlI�E1�5 Permit No. (�
1parlmxnt of JTtihlir �fetg
Occupancy & Fee Checked 4 `m
r 3M (leave blank)
�' BOARD OF FIRE PREVENTION REGULATIONS 527 CS1A 12:fl0
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR_ 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date,
,i)Q or Town of NORTH ANnOVER To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number)/5 �O`S ` V? JT
I- -, . , .n.A
Owner or Tenant
0-n
Owner's Address
Is this permit in ccnjur,c:ion with a building permit: Yes No r (Check ApprOoriate Box)
Purocse of Suildina i Utility Authorization No.
Existing Service Amos NlIqls Overhead _ Unegrnd El No. of Meters
New Ser,/ice Amps _J Vcits Overhead - Uncgrno — No. of Meters
Nuincer of Feeders anc Ampacity J / 1
�
Location arc Nature of Prccasee Eiectr:cai :Vera /�e'J �hG/OSeC f'l �OlJYM►
f Tctai
No. at L:gn:(ng Outlets �t�[\ No. o, Hc_t =s i No. ct Transformers K`,A
df�L/
I Above— In- —
No. at Ligr,nng FFxtures Swimming =cat grna. _ cmc. I Generators KVA
i
No. at Flecectacte Outlets / I No. of Cit _urners
No. of emergency ug
1 9arery Units
No. bt Switcn Outlets I
No. or Gas Surners
Total
No. of Ranges I
No. of Air Cerc. tons
Heat Tctat
total
No. of Oisoosals
No.at Pum..bs Tons
K'V
No. of C•isnwasners -
! ScaceiArea Hearing
KW
No. of Or;ers
I Heanna Oev:ces
KW
No. of No. of
No. of .Vater Heaters KPJ
If Signs Satlasts
No. :Hvcro Massage Tubs
; No. of Motors Total HP
OTHER, n e t�i e neU% 6U`/41I zCJyl`e
=IRE ALARMS No. of Zones
No. of Cetec:ion anc
Initiating Oevtces
No. at Souncing Oevices
No. of Sort Containea
Detec::oniSounaing Devices
Muntctoal Other
Lccat Connection —
Low Voltage
Winne
INSURANCE COVEF;AGE: Pursuant to the reeutrements at massacnuse- general Laws e — u0 = 1
1 have a current Liaeiiity Insurance Policy inc!uctng Ccmo:etec Ocerattons Coverage or ;ts suos:anual ecuivaient. YDS — —
nave sucmtttea valid proof et same to the Office. YES = NO — If ycu nave checxec YES. tease natcate the wpe of ove ge cy
cnecxtng the a0proenate cox.
INSURANCE = BONO = OTHER = (PeaseScec:ty) (ERotra on Oatel
Esumatec value of E! cat 'Nork S
Worx :o Stan ?n--
Signee uncer the Penal t peryu
FIRM NAME 3 "
Licensee
lnscec:ton Dasa ;acues:ec:
Rcugn "� v FFnai
UC. NO.
Actress
`j
as le -
OWNER'S INSURANCE `NAIVER: I am a re tnat the Licensee goes not nave Me insurance coverage or is suostanval eeurvaleAgent
autreo ov Massachusetts General Laws. ane that my signature on ^.:s Derma a0p(tcatton waives this reeutrement. Ow�� •
(P!ease cnecx one)
T Fes=
(Signature at Owner or Agent)
Tetecnone No.
c�5a�
N2 ? 420
Date ...... 9/W1..1J....
f'
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
g
0
This certifies that ............... — c
has permission to perform ...... .,t......' .e.. 4.) .............
�......... o
wiring in the building of ........C).....,/ct.. ��:�.�S.fJ..!�,r............................�
r v �
at ...... 7 5........l...................................................... , North Andover, Mass.
CU
�..�
Fee ...�J.
ELECTRICAL INSPECTOR
CV ( t76 lK'
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
Location 75 F,STt-2 <T-r?NE-Cr
No. / &4- Date '7
14°"7" TOWN OF NORTH ANDOVER
ptt.ao ,a,ti0
p Certificate of Occupancy $
^; Building/Frame Permit Fee $ o r
,Vs
ACMUS t� Foundation Permit Fee $ T
Other Permit Fee $
Sewer Connection Fee $
RECEIVED PAv„1�V��onnection Fee $
IG ij��I[�, $ �p
t.Ay
Building Inspac—tor
No. Andover Collector
Div. Public Works
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t LIIIIiIIiIIItwalt4 of _4H5*1MtftS Permit No. ?C
p
MeartmEut of Puhtic taf tU
. Occupancy &Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 peeve blank) (J `
APPLICATION FOR PERMIT- .TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
or Town of -LM- RTH NDOV R To the Inspector o Wires
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) Etre— t>lxr-e
Owner or Tenant T/ 70z::!g � 1315
Owner's Address t iJ ? ✓ ", v ' '
Is this permit in conjunction with a building permit: Yes ❑ No (Check Appropriate Box)
Purpose of Building �i!��` Utility Authorization No.
Existing Service Amps _J Voits Overhead ❑ Undgrnd ❑ No. of Meters
New Service Amps _� Voits Overhead ❑ Undgrnd ❑ No. of Meters
Number of Feeders and Ampacity Q%
Location and Nature of Proposed Electrical Work ��✓`���'►
H I No. of Transformers Total
No. of Lighting Cutlets I No. of ..ct Tubs KVA
r--
No. of Lighting Fixtures I Swimming Pool AboveIn-
grnd. i grnd. ❑I� I Generators KVA
i No. of Emergency Lighting
No. of Receptacle Outlets No. of Cil Burners I Battery Units
No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones
Total No. of Detection and
No. of Air Gond.
No. of Ranges I tons Initiating Devices
yea: Total Total
No. of Disposals No.of Rumos Tons KW No. of Sounding Devices
No. of Seif Contained
No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices
— Municioal
No. of Dryers I Heating Devices KW Local I Connection Other
No. of No. of Low Voltage
No. of Water Heaters KW j Signs Ballasts Wirino
No. Hydro Massage Tubs i No. of Motors Total HIP
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 the Office. YES = NO = If you have checked YES. please indicate the type of coverage by
checking the appropriate box.d�(T
INSURANCE lBOND - OTHER = (Please Specify)
/ (Expiration Date)
Estimated Value of E!ectricai Work S 10�0 1
Work to Start Inspection Date Requested: Rough Final
Signed under the. P1enalties of perjury:
FIRM NAME �/ Z lr—`' `� LIC. NO.
^ry
LIC. NO.
Licensee '��y^ --4` �� 1��"���—Signature
/�Y� /✓i Bus. Tei. No. 7
Address �/mac✓� /S,Cn �d ��C/ AIL Tei. No.
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage or its substantial equivalent as re-
quired by Massachusetts General Laws. and that my signature on this permit application waives this requirement. Owner Agent
(P!ease check one)
(Signature of Owner or Agent)
.eieohone No. PERMIT FEE 5
x-6565
r ,_���rYa �-._:-.-,;.w-,x;�;w.�-�.� �.�...L..�:�.r•�.-.�,.�ey,,,;�„�, f„a�.:.,yC_,.'�y�,...+.*-,.�.._
7-1
T Date .... ..... ....Jr
'tom
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
1H
r pi
This certifies that ..... .... .. . ..... ..................../.(.:..
has permission to perform f ,.. ...........
wiring in the buildi of
at ........6 ............1.... ...��........................ . North Andover, Mass.
SFS' !� qq
Fee...%......... Lic. No. ,l.l.....................................:........:..............
ELECTRICAL INSPECTOR
WHITE: Applicant CANARY- Building Dept. PINK: Treasurer GOLD: File