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HomeMy WebLinkAboutMiscellaneous - 77 MARTIN AVENUE 4/30/2018N_ O SV V c.n D 6 X . O � 00 Z, � D b m O z .. o m 0 m -QI Location -77 A o&,Y- o A -,*c No. MDate 7" TOWN OF NORTH ANDOVER p �3a p � „ Certificate of Occupancy $ Building/Frame Permit Fee $ 'SsAcHus�t Foundation Permit Fee $ DNVr Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL k2 $ nz, Building Inspector 47110/H145 35.00 PAID t Div. Public Works r Q 7 N O O � n i 9 Z 9 p w m w m r r 0 M 0 � r Fl w w Z r � r^ r z w o o o 0 - N C> s>> O w n n n 1 -4 r F i O z z z z A a A> N 7 N 7. O 0 it u m n ro a n N N Z 0 N p A 00 n p: c > i iz1 a a 0 z ai z ai p r O A Q a 7 N O O � n i 9 Z 9 p w m w m r r 0 M a u b 0 V m z m 0 z� i J 0 z 7 N ua > > w I p p w w w N 0 M 0 � r Fl w w Z r � r^ r z w o o o 0 - N C> s>> O w n n n 1 -4 F F i O z z z z A a A> N 7 N 7. 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CD 0 =r W -q CD Q) CD -.00 Cl) " = : CC 0 o 0 0 CW, n 0 LA.0 o CD S. cm S OCO to o =r =r. CD U;*: ma CD CD C-)= to 0 CD Cv CD n d y 0 0== ate: cn CD CD CD CD 0 cu W W CD i= 0 C7 Nj 0 = CD C3 cn G 0: �_ CD cn >= R 6 -VI TfZ �- CD nK, Err CD _c cn c 0 low mmq (n U) D 0 2 � �j 0 PL r- ro 0 r- OQ 10 rl n �d -r, o 0 a r- ro V) Irl 0 0 z o > 2 0 ::3 . ;; 0 x > rD > tTj z09 M I R r 014e Lfammunwr# of Mttnsnr*rtts Bepartment of Public 26afet19 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only t Permit No. � I , Occupancy & Fee Checked 3/90 (leave blank) ✓ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 1,2:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date -7/V& (MR, or Town of NORTH A IMER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Owner or Tenant r Owner's Address"-� Is this permit in conjunction with a building permit: Yes L� No ❑ (Check Appropriate Box) Purpose of Building Existing Service Amps 4&,)j Volts New Service Amps _J Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Utility Authorization No Overhead .❑ Undgrnd ❑ No. of Meters Overhead ❑ Undgrnd ❑ No. of Meters OTHER: { INSURANC COVERAGE: Pursuant to the requirements of Massachusetts general Laws _ ^ I have a cent 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 appro late box. ' --r( " Ler�/7 INSTANCE ONO = OTHER (Please Specify) rMQ ' r` ' ff (Expiration Date) Estimated Value of Electrical Work S Work to Start 7— —^5�L_ Inspection Date Requested: Rough 1�' �L c� `I _ Final Signed under the Penalties of perjury: FIRM NAME n LIC. NO. Licensee V Signature Ile LIC. NO. �Z ^ &2 Bus. Tel. Address /4 vx �� ). `t Alt. Tel, No. OWNER'S INSUR NCE 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 Y Agent� (Please check one) � Telephone No. PERMIT FEE S (Signature of Owner or Agent) x•6565 Total No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA No. of Lighting Fixtures Above In - Swimming Pool grad. grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets I No. of Oil Burners I Battery Units No. of Switch Ou!L No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and ^ Total No. of Ranges i No. of .Air Cond. tons Initiating Devices Heat Total Total No. of Disposals No. Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices Municipal I Local Other ❑ Connection C;; _• ""- 1 No. of Urye�s Heating Devices KW No. of No of Low Voltage No. of Water Heaters,. K`. I Signs : ,,�Ball�sts, .. Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: { INSURANC COVERAGE: Pursuant to the requirements of Massachusetts general Laws _ ^ I have a cent 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 appro late box. ' --r( " Ler�/7 INSTANCE ONO = OTHER (Please Specify) rMQ ' r` ' ff (Expiration Date) Estimated Value of Electrical Work S Work to Start 7— —^5�L_ Inspection Date Requested: Rough 1�' �L c� `I _ Final Signed under the Penalties of perjury: FIRM NAME n LIC. NO. Licensee V Signature Ile LIC. NO. �Z ^ &2 Bus. Tel. Address /4 vx �� ). `t Alt. Tel, No. OWNER'S INSUR NCE 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 Y Agent� (Please check one) � Telephone No. PERMIT FEE S (Signature of Owner or Agent) x•6565 `rw'i--.e�4�,•�:'�.'�6�.T�i �.`"+•eS�dw ��s'..,�.�-5`h--�'"y�rjl.c`��'i-•ai�a� �".�/,�yI•�6;'...s.+3.� 1 i,� -.._ ... • r��j n Date...... � ../ ....::. JQ 3V 6 NORTH °�t ``°:•'"° TOWN OF NORTH ANDOVER o p PERMIT FOR WIRING ,SSACHO This certifies that .....:il• , Q. . { �R.a has permission to perform ......4. t d .�....... �1e j, od ....... d t)......... - wiring in the building of ........ Ck C„ c qtr..QU4................................. at ......7. ...... 'iG.. ch ..,, Q .:............. North Andover, Mass... �22 Fee.... 5.J Lic. .......................................... ELECTRICAL INSPECTOR C, _ 10/95 11:42 5.08 PAID WHITE: Applicant CANARY: Buil V9 ept. PINK: Treasurer