Loading...
HomeMy WebLinkAboutMiscellaneous - 78 SPRING HILL ROAD 4/30/2018 (2)It, �. N° JjJ./ Date.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... ��. �..C......... ��. .: u c� .............. has permission to perform ....... S ........................................... wiring in the building of ...... ..r?...'...1......../............................................ at .....7. .� ......11........jl...!..:...1.....f�........................ .North Andover, zr assesFee...f��.. U.... Lic. No..I.�.?.r.... �". . J` ELECTRICAL I{ISPECTO Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer r Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked (Rev. 11/991 Inve blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (IvfECI 527 2.00 (PLEASE PRINT' IN INK OR TYP ORMATTOT� Date: !Q City or Town of: To the Inspector df Wes: By this application the undersign-ix5 n05�&of his o her mtc�4 to perfoynth; electrical work described below. Location (Street & Owner or Tenant Owner's Address on Telephone Na — Is this permit in conjunction with a building permit? Yes ❑ No � (Check Appropriate Box) Purpose of Building Utility Authorization Na Existing Service Amps / Volts Overhead ❑ Und;rd ❑ Na of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ Na of Meters Number of Feeders and Ampacity _ w +� Location and Nature of Proposed Electrical Work i'nrnniolinn niri.efll.....:.,.. r..LL .... L_-�]-._J L-.t_r__—__-_. _nrrr• No. of Recessed Fixtures lNo. -- - - - - r ••�^•• of Cet1-Susp. (Paddle) Fans Wim« ur uc r.u..w uv use frLroector pl rnreS. No. of Total Transformers KVA No. of Lighting Outlets INo. of Hot Tubs Generators KVA No. of Lighting Fixtures !Swimming Pool Above ❑ !n- ❑ rnd. ornd. o. o mcrgcncytgnung Battery Units No. of Receptacle Outlets lNo. of Ort Burners FIRE ALARMS INo. of Zones No. of Switches INo. of Gas Burners No. of Detection and Initiating Devices No. of Ranges lNo. of Air Conti. Torn No. of Alerting Devices No. of Waste Disposers licit Pump Number Tons JKW Totals No. of cif ontained Detection/Alerting Devices No. of Dishwashers Space/Arca Heating, KW Local Municipal Connection 11 Other No. of Dryers Heating Appliances KW ecunty bystems: Na of Devices or Eouivalent No. o Heaters KW ater°' ciz-s No. o ., Ballasts Data Wirine: Na of Devices or Eouivalent No. Hydromassage Bathtubs No. of itilotors Total HP Telecommunications Wiring: Na of Devices or E ui alent OTHER " Anadr additional detail ijdesired• oras required by the Inspector of ]Fires. 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 coverage is in force, and has tdubited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work $ 13 7V ' (Expiration Date) (When required by municipal policy.) Work to Start Inspections to be requested in accordance with MEC Rule 10, and upon completion. 1 certify, under the Phinsland penalties ofperjury, that the information on this appEcation is true and complete FIRM NAME: ADT Security Services -.Dr -. .ol 1 is, NH 03049 LIC. NO.: 1533C Licensee: John S. Bassett Signatu IC NO.: 1533C (If applicable, enter '•exempt" in the licetuenumberGne.) Bus. TeL No.: -603 594-5900 Address: U AIL TeL No.:_603 594-5928 OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby ivaive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No.PER1bHT FEE: S,3 t Commonwealth of Massachusetts City/Town of /Vjr To System Pumping Record Facility Information: System Location: /9 Address —A" M City/Town State Zip Code System Owner: Name: Adress (if different from location of pump) City/Town State Zip Code L?�k- Y1 C, - ///)L Telephone Number Pumping Record Date of Pumping 46 Quantity Pumped j� �,�� gallons Type of System—_X Septic Tank Grease Trap Other (what) System Pumped by: Company: ROOTER -MAN 46 Portland Street Lawrence, MA 01843 Location where contents were disposed: Signature of Hauler Date Commonwealth" /of Massachusetts a /�/G�, I'_�j 12 X012 City/Town of; TOWN OF NORTH ANDOVER System Pumping Record L HEALjH DEPARTMENT Facility Information: System Location: Addre/]ss� ����4 &d6UV,4 City/Town State Zip Code System Owner: C.0 Name( Adress (if different from location of pump) City/Town State Zip Code Telephone Number Pumping Record Date of Pumping /i % L% r Quantity Pumped gallons Type of System�_Septic Tank Grease Trap Other (what) System Pumped by: AC_cyz— 7 / Yl Company: ROOTER -MAN 46 Portland Street Lawrence, MA 01843 Location where contents were disposed: 0 Signature of Hauler Date 0 Commonwealth of Massachusetts City/Town of KOO ATI�wt K System Pumping Record FJA,� TOHEALi TMENV Facility Information: System Location: S no Address q8 om�- 6vp UI g�f5 City/Town State Zip Code System Owner: Name: Adress (if different from location of pump) City/Town State / 1, yZip Code/ wi I -,3 . / 8- - 7 Telephone Number ' Pumping Record Date of Pumping uantity Pumped� 1 cJVy allons t Type of System Septic Tank Grease Trap Other (what) System Pumped by: _:L) a 41-� ':1 ae-,J— Company: ROOTER -MAN 12 East Dracut Rd., Methuen, MA 01844 Location where contents were disposed: l�JSignature of Hauler � Date r rr '-.MME , ty�f"Q„ p7q., ORTH�A DOVER MASSACHUSETTS h7�YSY em', g-Recorrd' fiUn _Q{'�� 1 " ■�1�1 �kAli:if I ¢ 1't/ '`I L'. 1 • W mel i..IVED v,; } „ t DEP has Provided this form for use by local Boards of Health. T e Sy st P be submitted to the.local'Board of Health or other approving aut orifr�pi record must Ai Facility Information juY N 4 f AL T H U.-PARTMENT. important. Mi"Ung, out 1.: System Location:-..- foims. on the 'computer, use . only the tab.key Address to move your cursor - do not use the return City/Town tate Zip Code �� Y f' keY " 2 ,System Owner Name Address (if different from location Citylrown State Zip Code ` Telephone Number .:Pumping Record 1 { ,.1 •• P 1 1 Date of Pumping':,*,..,,.Date 2. Quantity Pumped: Type of system ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑' Other (describe); ;.: ' - ; 4 Effiuerlt Tee FOter present? . ❑ Yeso If yes, was it cleaned? ❑Ye* s ❑ No ,xi Y y. yl i 5 Gond n of.System t _ ks 8 Sy e"' Pumped By' ,, NVe�h/icle�Ucye/nn4e Number I LI/i . - _ t ,Company • , , � , , , t 4fAY� •Y Yu ` 7 Location where contents were disposed: t 1 1 e of Hauler,; , t. Date http,//www mass gov/de'pJwater/app rovals/t5forms,htm#inspect t5form4.docs08/03 System Pumping Record • Page 1 of 1 IY. 4gx ord o J4'}t� r �'�'y '• � ✓1\+l i:l !1.:.• : .:',:.�,.c«..,,I,y� �;;' dS��'i+ '{Ila;,,;.,',y,•;;,1�;,•;�.,"+��.!:'�' t±P'.has provided jhli ` be':ubmltted form for use by IQcal Boards of to'the.local'Soard o( Health or other 77, A: Facll(ty.lnforri"atlon J;rWhan' famg out 1.. System l.ocatlon, ony the tab kay Address U Lo move your •i':(l.d!• s''•°• 't}.I•�'.'''��<V'i 1'I i,lrl•° .1•'j:'�.:; ,,' SA. ealthM't"}�e Syste�.t 9 Recorc Appr Ina autfGoIt�H. T�nENT ar:or:• do Sgt; `uso'N'rotum V, ',,; ;; ,CltY/1'own /....,: �'y';aY�''t';'i,'�'.i, t.'.��I1• Yy'l1r+l .ly�1,1.i(i7�►t'`ly�/;'l,, ti;✓�ir,�.!,LYe'n''L'':"•,F.,,..• Stato D C od e}, m Ower',v.,�' �ir. ,�..; :�.`�l• ti�, �rAll.f�.�r) Krp•.l1i./; l,Yt •l'Nw�l��,t N/. � ' .a. � •1 `i � .ia;''%'•.if:r^d:ih; r:i .;:1•,�.'{'fir;.. ':• �� • 't�' °�`•:it),�u�\} .')%.;rtp»;:'+,:�' Ii•'q;.l'4. 1' ,r•,`i.. •q/.:•'•.w!.. .. �• , Nun 1••� 1r is • ..r� i. ,,' W'Addres•s (1(dUfonnt rom bcatlon) ,.•,.., • fb1/1 't , V � ,.rt' lJ 1. .IY C". •.Lp�., fi� �';� ✓,r .,� _ .. , tl plg.Rerord ' ":1'.��� :,;:>'�'.,'' •� R -Pum r,•>, Stale VP ode 7d'- Jrl'- �� �o 7e1ephono Number : ,, � fir• f yi:lli4/�+�I1�,i;11 y�•r;• p Z Date of Pum Ing Dae 2. QuantJty Pum ped: c. `TYP.e Pf.aystsm; , ❑' cesspools) Ieptic Tank • • '.�',., .-.,•,,':.; . ,.,. .. ';�� ❑ Tight Tank •t •' .. •,1�1 ,�4+., Al. �.: 1.�1111.,.11•�j,;l,:• '• - � .. . ' ..:+.., .::�"• :.,, .'(�.,.Other((dascrlbsr\J, ',. F J1{II/SI'•*✓.ry IN,`a.r'1.:1':,!'�il'.'M ii'•',',•! '. t Tae Flits{ "Efflus�,.,'{ �.,a•1..• �� ," , r,�sent?.,❑ •Ye o If s . ✓�fpii��l.1,, yes, was It cleaned? ❑ Yes ❑ NO .. .•1�.. .1 :{•.y.r,.�,•/'?i,%\ice' ,�44re'�'+ (1'rl 1I�fhJl- 1•L•r.. 1 t 1, /r I';;.,•1. ':ay';i�'+i yy r •�• .y:Y•tXi);!;i�yt•jl��. �iw• l ,lt,'u 1 ,, ��t•i".! ./.!1.1'1 ,�'1 :1 'LL� i.,' : . . •,T �'•',..i. � ' ' t.5'�� „� �. /,r { i(j��• /'al �i •a �i� • ,' � did, 1 �l:!::� /i•1%4;�.•lpVr?e�'YIC i''�•411;!1/1!.'1{+'(I�h .,`rl,'' ��, • :; •, .,(� .; ?`'1'��{ 1�1+. •.1 •Ifs;' 1', ;L;'1, ',5 �'ii i�.i{„✓'�%i�r7.,'r:r• I�rfN}+�:��4 lr•( .1�'V,r„Jr,�fl f' •iii'' loc1• f( i on.l�he�e co(1l�nts' ' � ;�,•%:. .. ;.. :'li'lr •..•., �,rt� Ni,l'1L 1' tjl ),N' ♦ �. ' .. ` M{. �.,�.. �'�:,,,��'�: 1"•;� rr��n. ii:�r�r •. .� �" Irr•1,, f1 ,���•i ., l., r.. ., 1 '+ . i11r;;.19•'.�•'Jii, } .r .1. t rl: d, � ,,t1,4''•r� �� t >•i::,�'�' 1: r+::J;rSlpnoku�ofHsub titfPJ/tiv�wrlmaO.r 8PP. .vaJI Worms,htm#Inspect . t5forrM,doa�f�IQJ,. •', ',; •, �1 .,' ,' �VohlcJe Ucen�e Number System Pumpinp Rocoro' Pike 1 �.'• IN U V V /jul YIjI . DEP has rdvlded p, this form for use by local Boards Health, ba subrrmltted to the.local'Board of Health >•. of The System Pumping Record m,;s: t ' " or other a"P oving " �.; „y. authority: A; Facility Inform tion . ,.: tY — -- System LocatJon; only the tab key Address ` to move your:: . atrtor • do pot '�,�`ui4the 'roturn'%' Clty/Town ,' � �;; Scat �. 4.,;1•��;�;;::�r, �"�'•�.�;�,,,.•;,, . •.:; ,.. .. Y,•..keys;�.:;1.�;�.$I' ••;r'';?.2.,''':.$St8 ' o Code IJ P y m ory n•@r'.:.�I>,rt•' •� � .. ,:fir , ; � :'Ivi•,; fs.i' ii i;:p,.�. '�.� 'n'••'e+J,''ty "'r7:'' 't',Yg':. Name. `v. :• ,�.,ry ., r. v.. ------------- ""' ' Addreas pf different from location) ;ti • - CttyiroWR :' State +^ �\ `Telephone Number pUM.pl ' ff;,/116,1:11r r�r1�c.;.:JpLIY,{f�`'i'•,''!'Ly�,'" �r• ;Q Date of Pumping l: LSI YP.9 9 SY3terh:: Q .. Cess �.J.Other (desalt (fluent Teta Flite{ preient? .,0 Y re'•rah!:/+i r111��f�n n'nt<''QvIw1 ...:r•1;� . . ..,.,' .•,•r'Y;�l•„i: �'*�Gi;<;: ••Trr,�i ^''';• ? v.n.; l; rr •fi7v��,}.;.rr'p.'.;•; .. •i. ,t%.t fi.,., as•r N'll�•1ry' ?i•t)�J;.•.:+:r: �I,t' •� t�t�.. .', .-;T: �•, : z: � L•O� 't' rig i'.: d ., : • '.:. , r f}a,`: •:;:'f:'%�'.. on.wflere conte e.re'dl tits,W, ;3posed; 'It`d• ,•• •ri:1 t.i. ���''':,��:'' ?. `;a`: a•., ;1' ;r;�l�j . w:j1 !r. �•t�r'l.�i f�'.�:'.i)ir.t•,','.. :I. •'P'•}•. `r :,,•.'; `.rr. f"l.l )r:!:'.: t, f• , Sanatur9 of Hauler;, htfAJ/www.mass.gov%de!water/apprCvajs/t6forms,htm#Inspect • t5forrM.doa!06/Q3 ' � • . . Quanuty Pumped If yes, was It cleaned? -•...�rlw I�wlwol System PumPIn9 Record ' Paye I cf DEP. hai ordvided Olifo• rm for Use 1 be submIttid to the.local' Board of H Ai Facility .Inform -pition 'I�orbmt:; System L6Cat1on.,'-'.1-. tit u$e oro M tab key Address to move your:: do..Pot CItV U34 the ...-System Nner':,' ':r. YS ETTS . .' l6c6l Boards of Health. The System Pumping Record must th or other approving authority. TCVVN OF NORTH V Z - - State Name State C7 ZIP Code —50 Telephone Number 'PUMP1.n0:.R6.9mord 1 Dato; ot Pumpingoale 2.QU andty Pumpec. G810n3 3,! .Type qfsystem:_❑ cess000l( 0eptic Tank ❑Tight Tank Other Effluent Tee Flltee ptiient?.❑ 'Yes. If1. yes, Was It c . leaned? D Yes ❑ No 0 US W C—r IR 6mped S' C-) 0. e hide U 11 cen*e Number Aw he Locatlon.wre C.0 loposed: Date 'W.MnigoWde�Vw-i-*/bMQV6,Is/t5forms, htm#lnsP ect � SYSIBM P umping Record Page I of 01-1 gujjoj 1l U6 no If UJ?rr uj V) op u 0 J� 6ujdlwnd g Cj Commonwealth of Massachusetts City/Town of ��� �/ ��.�;� System Pumping Record FOCT 14 2008 Tovi!, ti a ANF�n , Facility Information: u n . System Location: nC Addr ~ ess Kf City/Town d State Zip Code System Owner: Name: Adress (if different fromlocation of pump) City/Town State Zip Code �oq - U L Telephone Number Pumping Record Date of Pumpin Quantity Pumped UV gallons Type of System--Y—Septic Tank Grease Tra P___.___Other (what) IcUe System Pumped by: l `q e V - Company: ROOTER -MAN 12 East Dracut Rd., Methuen, MA 01844 Location where contents were disposed: 01 Signature of Hauler Date ii Commonwealth of Massachusetts City/Town of Nd Y+ andoVt'Y"" System Pumping Record Facility Information: System Location: q3 601/4 dill Address City/Town State System Owner: n Name: ` Adress (if different from location of pump) City/Town RECEIVED JUN - 9 2009 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 0 I 1�1-1 s Zip Code State Zip Code —7 q-7R�-640 - Dq l 0 Telephone Number Pumping Record Date of Pumping �" Quantity Pumped 5d Ugallons Type of System_�—(Septic Tank Grease Trap Other (what) System Pumped by: I L r eq Company: ROOTER -MAN 12 East Dracut Rd., Methuen, MA 01844 Location where contents were disposed: J� f Signature of Hauler Date' Commonwealth of Massach se s City/Town of 000h 0.1 v System Pumping Record Facility Information: System Location: Address City/Town System Owner: Name: (�o oq IVED WAN ? `I 2010 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT or? (11PC( State Zip Code Adress (if different from location of pump) City/Town State Pumping Record Zip Code q _1 L0q-01(70 Telephone Number Date of Pumping I -� f I -� (6 Quantity Pumped c4 �SV _gallons Type of System Yseptic Tank Grease TrapOther ( what) System Pumped by: Company: ROOTER -MAN 12 East Dracut Rd., Methuen, MA 01844 Location where contents were disposed: --6. /_ `j t) Signature of Hauler Date �� U� 4 Vv Of I'vlassachuset,4-s M Pumping Record tV orm ati on: r State i U Ifel-Ult from iocation of pullp) t a t C p 1 i.�Mipij-ig Rlelcord itity /V seotir ank &cas- Trap M hv fil-A V L te f I A IlIq 10 TOWN OF NORTH ANI)OVER HEALTH EXPAMT �MENT ip q7 - � -&5 y oci Teielphon -- , . Ile Nur-riber tiv'C-) T itfARl A 46 Po"and streetlt-awj--,.-jc.e, _js, rl A a IL n—I Commonwealth ®f Massachusetts Cite/Town of IU6Mi N6W eI System Pumping Record ,Tt ,,NN OF NORTH WOVT R Facility Information: System Location: Address vs - City/ own. State `Zip Code System Owner: —(46q X� Name: adress (if diferent from location of pump) City/Town Pumping Record State Zip Code -�0- l)q- Telephone Number Date of Pumping !/ Quantity Pumped J gallons Type of System—)CSeptic Tank Grease Trap Other (what) System Pumped by:... l Company: ROOTER -MAN 46 Portland Street Lawrence, Mtn 01843 Location where contents were disposed: � Signature of Hauler X Date Commonwealth of Massachusetts City/Town of go(�%dDvv System Pumping Recor Facility Information: System Location: Address System Owner: r + Name: '(OWN ur Adress (if different from location of pump) City/Town State Zip Code Telephone Number Pumping Record Date of Pumping 4 Quantity Pumped LZ� gallons Type of System__kSeptic Tank Grease Trap Other (what) System Pumped by: -.6k4 bIL i1wD Company: ROOTER-Jq 46 Portland Street Lawrence, MA 01843 Location where contents were disposed: Signature of HaulerDate I l