HomeMy WebLinkAboutMiscellaneous - 8 EMERSON COURT 4/30/2018IN
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s
3.470
This certifies that
Date ... /-. 7 � 7-), �� n'q/
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
has permission for gas installation
in the buildings of
'A. ./j..........
,........ !'s!rr!f......
at . < ............ - ... , North Andover, Mass.
j
Fee `? ...... Lic. No%;� i''? .. ..........................
GAS INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIT'ORM APPLICATON FOR PERMIT TO DO GAS FITTING
e or print)
1-1UK I H ANDOVER, MASSACHUSETTS
Building Locations Vv hp �'
Owner's Name
New Renovation Replacement
Date 7 J Klx� 9 ��
Permit 9 (-3 'U
mount S
Plans Submitted .-
(Print or ) Wd4
v/1,)m
bxNamJ/1�/gam � �
usiness Telephone
NamF of Licensed Plumber or Gas Finer
Check one: Certificate Installing Company
�w
Corp.
Parmer
INSDR.-k iCE COVERAGE Chec. oV.
I have a current liability Insurance policy or it's substantial equivalent. YesNo
Ifvou have checked ves, pleas . .
dicate the type coverage by checking the appropriate bo
lli
Liabilin, insurance policy Other type of indemnity Bond
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 t at my signature on this permit application waives this requirement.
hereby certify that all of the details 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 installa 'o�-ode
r Permit Issued for this application will be in
compliance with all pertinent provisions ofthe :�lassachusett afChapter I t' e General Laws.
By:
Title
City/Town
.4PPR01v"ED(tiFric;: i,sF !mn.Y)
Signatut e of Licensed Plumber Or G Fitter
Plumber J -7,-Z 4�
Gas Fitter Ucense iNumoer
Master
Journeyman
r
d.
Mt
(Print or ) Wd4
v/1,)m
bxNamJ/1�/gam � �
usiness Telephone
NamF of Licensed Plumber or Gas Finer
Check one: Certificate Installing Company
�w
Corp.
Parmer
INSDR.-k iCE COVERAGE Chec. oV.
I have a current liability Insurance policy or it's substantial equivalent. YesNo
Ifvou have checked ves, pleas . .
dicate the type coverage by checking the appropriate bo
lli
Liabilin, insurance policy Other type of indemnity Bond
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 t at my signature on this permit application waives this requirement.
hereby certify that all of the details 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 installa 'o�-ode
r Permit Issued for this application will be in
compliance with all pertinent provisions ofthe :�lassachusett afChapter I t' e General Laws.
By:
Title
City/Town
.4PPR01v"ED(tiFric;: i,sF !mn.Y)
Signatut e of Licensed Plumber Or G Fitter
Plumber J -7,-Z 4�
Gas Fitter Ucense iNumoer
Master
Journeyman
3649
Date....'`'//O ..........
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that
.............................................................................................
has permission to perform ................ J ...............................
wiring in the building of
1 ...................................
of ................c C 7' , North Andover, Mass.
...... .............
pied. d: :.......... Lic. Nod.!../�.......,- �...... �...... o......
ELECCRI IIVSPE R
Check # /w
_ "'� l .ommonwaa[1h o�ira�ac%rc�sl� Officisl Use Only
Permit No. Ye? .
JJaPa,,j ndnj o�,.tiri �awicae
BOARD OF FIRE PREVENTION REGULATIONS Occupancy.and Fee Checked
Rev' 11/991
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 ChIR 12.00.
(PLEASE PRIiVT IN INK OiZ TYI'L- .•ILL INFOXV.-IT'ION) Date: 2 d Z.
City or Town of: AA OV -d— To the Inspector o FVires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number) 1A1yf C'
Owner or Tenant U) (X4 &14TelephoneN'o.
0►vner'sAddress A0 t� odrlilgz 2)1? 4 68 ZOi3
Is this permit in conjunction ►vitla n building, permit? Yes ❑ No. '(Check Appropriate Box)
e� /� .t
Purliose of Building C�CdS j-'4Kltaj Utility Authorization No.
Existing Service yQy Anlps /&/d4(6 Volts Overhead Q Umdgrd 1,8j No. of Meters'.
LewService 5 F- Anips /. Volk Overhead 0. Undgrd Q No: of Meters.'
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
.1` Con+ letion " the (ollrnvin t
a b! b
No. of Recessed Fixtures
Q
No. of Ceil.-Susp. (Waddle) Fans
e IM a vaned b+ the !ns' cctor onvires.
N No. o 'otal
fransformaers KVA
No. of Lighting Outlets
No. of I -lot Tubs
Generators K1rA
No. of Lighting Fixtures
S►iimming Pool Above ❑ ln- ❑
t o. o mergency rg t mg
Mid. rnd.
BatteryUnits
No. of Receptacle Outlets
No. of Oil Burners
ZFIRIEALARINIS
No. of ZonesNo.
of Switches
No. of Gas Burners
o Detection and
Initiating Devices
No. of Ranoes
b
Total
No. of Air Cond. Tons
No: or Alerting Devices
No. of Waste Disposers
Heat Pump
Number
—
Tons
INO.
of el - o.ntained
-
Totals:
Detection/Alertina- Devices
No. of Dishi►•ashers
Space/Area Heating KW
Local 131V unicipa
Connection Other
No. of Dryers
Healing Appliances KW Security Systems:
No. o. of Wafer
No. of Devices or Equivalent
No. of No. of
I-Ieaters KW
Data Wiring:
Signs Ballasts
No. of Devices or E uivalent
No. Hydromassage BathtubsNo.
of \lotors Total i F 1 elecomnanmcatrons 1 hang:'
No. of De -,•ices or r-,- —len
OTHER:
Attach additional detail ijdesired, or as required by the Inspector of ]Vires.
IivSUIQUNCE COV EIUIGE: Unless waived by the o►vner, no perrnit 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 fn force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSUR�\NCE [Y BOND ❑ 0"I'I-lER ❑ (Specify:) t!��tb�/jy� Aat
Estimated Value of Electrical Work: (When required by municipal policy.) (ExpDate)
Work to Start: Z Inspections to be requested in accordance with MEC Rule I0, and upon completion.
I certify, under th pains acrd penalties of perjary, [hat the infortuadorr art this application is tare and complete:
VAW1LINA V11!: tGG v i ad ,ec r' _
Licensee: �ltG �r' CI Signature
((jai:l+licable, enter• "�:cennpt " in lite license n uuber line �
Address:bb�L
OWNER' INSUR:\tiCE WAIVER: 1 am a►vare that the Licensee does
requiral by law. By my signature below, l hereby waive this requirement.
Owner/Abent
Sionaturc 'Telephone No.
LIC. NO.: y -A•
LIC. NO.:_F'.a.05'Je)
�!�y
Bus. Tel. No.•Alt. Tel. Noinsurance coverage normally
I am the (check one) Q owner0 owner's agent.
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