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Home My WebLink AboutMiscellaneous - 82 LONGWOOD AVENUE 4/30/2018-0 -i 0 z m o 0 Z 0 tl Z 0 m Ja _ CDP.:n20ntucAL of l Ja:l:Iach. ,.alb. 2v?at•lment o��tiro Jaruire3 BOARD OF FIRE PREVENTION REGULATIONS -r• r- - Offilcial Use Only PermitNo. i r Occupancy and Fee Checked [Rev- 1/071 (leave blame) APPUCAT90-N F®R PERMIT TO PERFORM ELECTR9CAL WORN All %vorlc to be performed in accordance: %vitli tlieMassaelrusett_sElectrical Code (KEP. 537 MR 12.00 (7`LE,ASE PRTNT INflVK pR TIPE ' LTID11 j Date: ) ZV /„3 City or Tolvn of: To the IrTsp tot' of FT fre—S: By this application the undersigned gives notice of b- or liar intention to perfo die electrical tivorlc described below. Location (Street & Number) (,t,y Owner or Tennnt Telephone No. Owner's Address Is this permit in -conjunction with a buildr permit? Yrs No, Or (Check Appropriate Box) Purpose orDuilding If >W7 /til..__ Ute-1ity Authorizntion No. Existing Service Amp / Volts Overhend ❑ Tlndgrd;❑, No. orNcters New Service Amps / Volts Overhand ❑ Undgrd ❑ No, Of Meters Number °[Feeders and Ampacity Location and Nature of Proposed Electricnt \Norte ;�/�®_ ir�+f /�'1�„>,✓.� 'PuZ31w �a %P•.oT� i Cods Com letion o%flea folloivinpr !able molr be lvafred bit flee I No, of Recessed Luminnires No. of CeiI-Susp. (Paddle) Fins . J nspeclaralb No. of Ibtal ''ransrormers ]CVA No. of Luminnire. Outlets No. ofEat Tubs Generators ICVA No. ofLyminnires 5wimmingPool Above ❑ In- El1 Qrnd. Qrnd. 0. o l MergencyiL,rg ong I3nttc Units No..ofReceptacle outlets No. of Oil Burners 1=1 ALARMS No. of Zones No. ofsivitches No. ofGnsBurners No. of Detection and Initiatine Devices No. of Rnnges - No. arAir Con d. ToLal Tons No. ol-Alerting Devices g No. orWnste Disposers HentPump Totnis: umber Tons KW o, 0fSelt=C0ntnined Detection/Alerting- Devices No. ofDistrtivnshers Space/Area Henting ICW Local ❑ Municipnt Connection ❑ Other No. of Dryers No. of Water KW Heaters Ranting Applinnccs KIN No. of Na. °1' signs Ballasts Security Systems -.:t No. ofDcvicas or 1; uivalent Datn Wiring: No. of Devices ora uivalent NO. Hydromassage Bathtubs No. Drmators Total IV Telecommunications Wiring: No. of ]Devices orEquivalent Aifaclr additional delafl ifdesired, or as required bit the Inspector of 1 Estimated Value ofEleetrieal Work -'� (When required by municipal policy.) Work to Start: "—� Inspections to be requested in accordance with IvgCRule 10, and upon completion. INSURANCE COVERAGE: Unless waived by ilia owner, no permit for the performance oFelectrical work may issue u the licensee provides proof of liability i urance including "completed operation" coverage or its subslandal equivalent 'I undersigned certifies that such cove a is in Force, and has exhibited proof oFsa to lee p i[ issuing office. CHECK ONE: rNSURANCE BOND ❑ OTHER. ❑ (SpeciFy:) 1 celY , ttrlder the pn' anfl penal ' of 'rlsy, If l 11te ' rnlutiarr al! Ile si �r r 1 ant! !r 1s true rind VIRM NAME: PP camp/ate_ �.► �' 1(r LIC. NO. Licensee:v ign tur'en ,e= Lft LIC. NO• iifoppllcable„ ler " " i Pile n lin license o i UU G'I Bus. Tel. No.-4-72f— Address: h Alt_ Tel. No *PerNI.G_L. c. 147, s, 57-61, security/work requires Department ofPublic Safety "S" License: Lic_No OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage none: required by laty: By my signature below, I hereby waive this requirement_ I am the (check one) ❑owner [l owner's s =-Owner/Agent _ :....: ;.: Signature _ TelcphoneNo. d'LR11d3T. FEE: S o to tOf - srq�x�6.... r_��Town of Andover 36 Bartlet Stree _ a Electrical Inspector Andover, MA 018 Paul Kennedy (978)-623-8306 ELECTRIC RNUT FEES Fax Number: (978) 623-8320 (revised September, 2012) Office Hours: 8:00 a.m. - 10:00 a.m. Commercial Base Fee $50+ $1 each device Residential New Dwelling Up to 200 amp service Each add. 100 amp's $225 $20 Multi-Family New Condo/Multi-Dwelling (per unit) $225 Residential - Multi-Family/ Single Family Service/change/ alterations 1 phase - 200 am $60 3 phase - 200 am $110 Each add. 100 amp's $20 Additions/Renovations/Replacements (Maximum.Fee $225) Outlets, switches, plugs, luminaires, etc. $50 (min. fee) $1 each device Residential / Commercial ($50 base fee+) Appliances $50 (min. fee) $10 each appliance Air Conditioning and Heat Pumps $50 Temporary Service $50 Residential Generators/Solar Panels (service additional cost) Additional Equipment $100 (base fee) + $25 each Commercial Generators/Solar Panels (service additional cost) Additional Equipment Per KVA $100 (base fee) + $'; + $25`eaeh Residential Audio/video/data/phone-systems/ Fire alarm/security systems $$0 Commercial Audio/video/data/phone-systems/ Fire alarm/security systems $50 base fee + $60 Commercial New Construction and Alterations Base fee S50+ Per 1,000 sq. R. of Construction Space $100 Service/Change up to 200 amp See Electrical Ins ector for price above 200 am $150 Maintenance Permit/Repair Blanket Permit (up to two electricians) Over two electricians (per air) $200 $50 Office Furnishings/ Partition Relocations Per Circuit $50.00 (base fee) + 'J10 Transformers (non -utility owned) $50 Miscellaneous Carnival rides X50 Demolition $50 Feeders or sub-feeders and panels (each 100 amp. capacitor fraction thereof) $30 Motors, per hp or fractional part thereof $4 Siding (re-securing service, lights, plugs) $50 Signs $50 Meters $20 Swimming Pools In-ground Above-ground Commercial $100 $50 $200 General Fees Re-Inspection Fee $50 Inspection after hours (minimum fee) $200 Working without a permit Double Permit fec M MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO 00 GASF4�I;ING"a (Print or Type) j? htN z0//e6� ltasz. Date v� 8v 1g�_ Perm't x _ _ Butdun t o=ticn 0,,'vA Owr es Nam., /E,yLTi's• Type of Oc0jp&ncy New p Renovation ❑ Reptacemerd [ Plans Subm1tted:. Yup NOD InS'aniN Comp=j Namc Eastern Propane Gas Inc. Address 131 Eater Street = t)ar�vQrS _ r!acc _ 01 921 susirKss Tc;cphone 508-774-1930 ,G frame of Ucensed Plum! es of Gas F4ter 1T 9 s e /27% ... c!T Corporation O Partnersh)p O FirmJCo. Cextifute'. INSURANCE COVERAGE: . I have a cuncr+t lta hsurance pdicy or Its subean;tal equMa!eni which meets the requi. errr_nts of MGL Ch. i42 - YC S 42.Ycs LEY No O N you t,:. chcckcdXI�. p.`c-ase L^.diczte the :;—pe cc -:e age by cZed.ing Vhc app!opr�zzte fix_ A lia,bility kuurnce policy gr__� Other type of indemniy O Bond O OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the tnsvmnce coverage required by Cth: Ater 1<2 of the Mass. General Laws. and that my signt;ure o:t this pcmtit appiiea;ion waives this requirement Check one: OwnerO Agent O S,gna:ure o! Owner a Ow wC& 4ent i hereby a :iy v.3, in of the Ce:sits and inix:nation I tu.e submitted for enti!tcl in t.apli: ation we We and a=rra;e to the test of my knv:4edge las lJu; a! plumbng w_:i and ins allatioas perform -Ad urde: L'se perm'V4 r6.1 for V's z;) r, t;on vAl be in COfl;AianCfl with all peniicnt provisions of vc 1Jsssa tLsei'S Sate Gas Code "Ct•.aater 142 of the rtl eY T _ of Lixnse: ris^:azure of um .sed un be: v Gas filler True casfrtter Plaster Licease,.t� mbe:. pty/To. r� Journeyrun 1�PP r r`: u �� r a in u a . X 2 Q ti ., a 0 cc r — 07 ¢ in ¢ O O W W J M C O v O H � X r O F' < �' Z= o *" y c r C0 y $ W o d oic '� t - A W cc W b W J Z rJ < W C „ C: W p { C C LJ I- u N C W W r N O> O 2 ti 0 C O 4A S { W y G W O X< c{{ O O a O d v }- Xc> 5t)8—aSbrT. a&SEMENT 1ST FLOOR 2ND FLOOR 1 3RD FLOOR 1 4TH FLOOR , 5TH FLCOR •tTH FLOOR 7TH FLOOR 979 FLOOR InS'aniN Comp=j Namc Eastern Propane Gas Inc. Address 131 Eater Street = t)ar�vQrS _ r!acc _ 01 921 susirKss Tc;cphone 508-774-1930 ,G frame of Ucensed Plum! es of Gas F4ter 1T 9 s e /27% ... c!T Corporation O Partnersh)p O FirmJCo. Cextifute'. INSURANCE COVERAGE: . I have a cuncr+t lta hsurance pdicy or Its subean;tal equMa!eni which meets the requi. errr_nts of MGL Ch. i42 - YC S 42.Ycs LEY No O N you t,:. chcckcdXI�. p.`c-ase L^.diczte the :;—pe cc -:e age by cZed.ing Vhc app!opr�zzte fix_ A lia,bility kuurnce policy gr__� Other type of indemniy O Bond O OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the tnsvmnce coverage required by Cth: Ater 1<2 of the Mass. General Laws. and that my signt;ure o:t this pcmtit appiiea;ion waives this requirement Check one: OwnerO Agent O S,gna:ure o! Owner a Ow wC& 4ent i hereby a :iy v.3, in of the Ce:sits and inix:nation I tu.e submitted for enti!tcl in t.apli: ation we We and a=rra;e to the test of my knv:4edge las lJu; a! plumbng w_:i and ins allatioas perform -Ad urde: L'se perm'V4 r6.1 for V's z;) r, t;on vAl be in COfl;AianCfl with all peniicnt provisions of vc 1Jsssa tLsei'S Sate Gas Code "Ct•.aater 142 of the rtl eY T _ of Lixnse: ris^:azure of um .sed un be: v Gas filler True casfrtter Plaster Licease,.t� mbe:. pty/To. r� Journeyrun 1�PP r r`: u �� r x o� • h • W G O ' � f Rl li O w Z Z ' f - r LL p O • J C ' X p O O v O = O o r v � s r o W O V { • J 4 .. u u Rl li w Z ' f - LL p C ' O = X OTI K 5' � CD 0 C—D OQ ::3 > zo > ' OQ CD .43 CD CII CD :j 0 z Z a 0 m m