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Home My WebLink AboutMiscellaneous - 89 BRUIN HILL ROAD 4/30/2018 (2)4 Date./:-:. 7 .-..`:. -'- 1 '- TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... ......S`?'�' �' �� . `. has permission to perform ......................... plumbing in the buildings of .... .� .� ! h r c . ............... at .. . `.i... ........... . North Andover, Mass. Fee.,.'... Lic. No...?.?.? . ............. . PLUMBING INSPECTOR Check # 61 .) f S 5101 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print -or Type) : A✓ " i If`r A^ , Mass.. Date W Building Location (P2 iLL % h �i �� Owners Name D&T Type of Occup New ❑ Renovation ❑ Replacement 21 FIXTURES Permit # 5^ 1' O h Yes ❑ No ❑ Installing. Company Name l D aEe7 a. �PM ►? 1 A 7 Check one: Certificate Address o CO/4C N 02r4n 1 L,�) ❑Corporation FYI E % Nt' Fn1 ill A 1 FVC% ❑ Partnership Business Telephone-_ �� , _ l'77 1 9-A-rm— /Co Name of Licensed Plumber ig • INSURANCE COVERAGE: I have acurrent }ability insoura ce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes B' If you have checked ,res, please indicate the type coverage by checking the appropriate box. A liability insurance policy Z?/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 that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Anent Owner ❑ Agent ❑ l�a�ovy -uiy wat a i or ine aetails and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations ormed under the permit issu for this pertinent provisions of the Massachusetts State Plum ' g e and apter of the eral LawplicaUon will be in compliance with all Title re o �censed lum er City/Town Type of License: Master Journeymah ❑ APPROVED 0 IC US ONL License Number C) 5 JcJ Y • • mum• ■■■ �■■■�■.. ■.■■■ �� ■■■■■ INN IMI ■��f��OMNI IW4a• • NONE IMMEMEEMMIMEM IM mum soon 0 ONE .. ■MENIMEMEMNIM IME 0 IMM no 0MEN NONE Installing. Company Name l D aEe7 a. �PM ►? 1 A 7 Check one: Certificate Address o CO/4C N 02r4n 1 L,�) ❑Corporation FYI E % Nt' Fn1 ill A 1 FVC% ❑ Partnership Business Telephone-_ �� , _ l'77 1 9-A-rm— /Co Name of Licensed Plumber ig • INSURANCE COVERAGE: I have acurrent }ability insoura ce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes B' If you have checked ,res, please indicate the type coverage by checking the appropriate box. A liability insurance policy Z?/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 that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Anent Owner ❑ Agent ❑ l�a�ovy -uiy wat a i or ine aetails and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations ormed under the permit issu for this pertinent provisions of the Massachusetts State Plum ' g e and apter of the eral LawplicaUon will be in compliance with all Title re o �censed lum er City/Town Type of License: Master Journeymah ❑ APPROVED 0 IC US ONL License Number C) 5 JcJ F m 714 Date..... ... .... .. ........ .. kORTM TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... C V ...... has p&mission to perform .......... R. wirm�in the building of ....... ?7-6e.qr), ..... ................................ i at ......... ....... North 0 , ass. 7, ...... ...... ............. ............ . Fee .... . ..... Lic. No/- 7�� ,7,,,,..Ov ......... Check # /0� ECrRICAL NSPECTOR $160 VJ-LwoarcMsar wttsr PLEASE PRINT IN INK OR TYPE ALL INFORMATION City or Town of: By this application the undersigCnedd gives notice of his or her in Location: (Street & Number) WSo, 0p r-ri To the. Inspector of Wires: to perform the electrical work described below. Owner or Tenant _ LI 1A2fi/ j Gji '' Som 7 9 ) Owner's Address: Is this permit in conjunction with a Building Permit? .Yes a No, (Check Appropriate Box) Purpose of Building: Utility Authorization n ' Existing Service: Amps / Volts Overhead p Underground.0 #'of Meters `p New Service: - Amps f Volts Overhead 0 Underground.0 # of Meters: :t Number of Feeders and AmpaW. . t a Location and Nature of Proposed Electrical CAT15'(z, INSURANCE COVERAGE: Unless waived by the owner. no permit for the performance of elechfcal work may issue unless the licensee provides proof Of liahllity insurance including `completed operation' coverage or its substantial equivalent The undersigned certifies that such coverage is M force, and has exhibited proof of same to the permit issuing office. 'CHECK ONE: / INSURANCE BOND o OTHER a Piease spew. Estimated Value of Elecbipl Work 5_/ � ' (When required by municipal policy) Work to Siar`t � � . 1 eeriHy, under the pains and penalties of Inspections to be requested in accordance with MEC Rule 10, and upon completion. ry ,, pen perjury, that the information orf this application is true and complete. . Firm Name: �1 �v �, C� t r YC.�` Gni �i��' . • Licensee. 1-1 C ,-41 Signaturh (ffappticaftle, enter Address: OWNER'S INSURANCE WAIVER: I rim swam that the Lieensee does not hav waive this requiremetsL 181111 the (cite& one) Owner 0 OR Agent n LIC. x LIG V—26Y 7 Bus. Tel. 4053 3 c� /ci ! ) AIL Tel. r 05')Iq 03 11 O insurance coverage By my No. of Recessed Futures No. of Ceti.-Susp. (Paddle) Fars No. of Transformsm Total KVA No. Of Lighting Otillets No. of Hot Tutu Generators KVA # of Emergency Ughft Satisfy Units No. of Lighting Fbdures Swimming Pooh Above ground a In Ground a No. of Receptacle Outlets No. of Old Burners Fire Alarms # of Zone; # of Detection & initiating Devices # of Sounding Devices: No. of Switches of Ga No. s Burners # of Self Contained Detedtionlsouri ft Devices No. of RangesNo S of Air Conditioners TOTAL TONS: No. of waste Disposals Local n - Mun t Connection o Other e Heel pump Totals: Y sysntt Number. TONS• KW: No. of or Devices or Equivalent No: of Dishwashers Space (Area Heating: KW Data Wiring,No. of Devices or Equivalent: No. of Dryers Heating Appliances KW Teledommuni ations No of Devices orEquivalent OTHER; No. of Water HastermKW No. of signs, —# of Ballasts: of Hydro Massage Tubs No. of Motors Total HP INSURANCE COVERAGE: Unless waived by the owner. no permit for the performance of elechfcal work may issue unless the licensee provides proof Of liahllity insurance including `completed operation' coverage or its substantial equivalent The undersigned certifies that such coverage is M force, and has exhibited proof of same to the permit issuing office. 'CHECK ONE: / INSURANCE BOND o OTHER a Piease spew. Estimated Value of Elecbipl Work 5_/ � ' (When required by municipal policy) Work to Siar`t � � . 1 eeriHy, under the pains and penalties of Inspections to be requested in accordance with MEC Rule 10, and upon completion. ry ,, pen perjury, that the information orf this application is true and complete. . Firm Name: �1 �v �, C� t r YC.�` Gni �i��' . • Licensee. 1-1 C ,-41 Signaturh (ffappticaftle, enter Address: OWNER'S INSURANCE WAIVER: I rim swam that the Lieensee does not hav waive this requiremetsL 181111 the (cite& one) Owner 0 OR Agent n LIC. x LIG V—26Y 7 Bus. Tel. 4053 3 c� /ci ! ) AIL Tel. r 05')Iq 03 11 O insurance coverage By my