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Home My WebLink AboutMiscellaneous - 9 PLEASANT STREET 4/30/2018a't Date .....:... 6 . TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that ................................................. �q � has permission to perform .... .� ..,,.�..................*..g .................................:. wiring in the building of .......... " D �/ D at ........:5 =............. .......... . North Andover, Mass. Fee ..................... Lic. No. `......... LEMICAL INSPEc-r6R j Check It �Z�� J( 8313 r 1CX Commonwealth of Massachusetts ► "� Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. ?:3 / Occupancy and Fee Checked [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: &Ar4 a,5- " gwr City or Town of. NORTH ANDOVER To the Inspector of ices: By this application the undersigned gives notice of his or her inteZee ion to perform the electrical work described below. Location (Street & Number) 9 AeC5clyt1- . Owner or Tenant Telephone No. Owner's Address 1971'1L: Is this permit in conjunction with a building permit? Yes ❑ No �r (Check Appropriate Box) Purpose of Building &6&f+uG1f- Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Tota Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ rnd. grnd. o.. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: I Number .... Tons K No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ MunicippConnect oln ❑ Other No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability ins nce including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such Covera is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under th ains and p na t' s of perju y hat the information on this application is true and complete. FIRM NA ��I/r l/U%- LIC. NO.: License jA(S,46,0 1%0 10 A19 Signatu LIC. NO.:69&7- (Ifapplicablnter" en t" in the license iar. ni er 1'ne.) Bus. Tel. No.: Address: �0. x r t 5 : t. o AOL, /' AA pt Alt. Tel. No.. —- *Per M.G.L c. 147, s. 57-61, security; work requires Department of Public Safety "S" License: Lic. No. 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 waive this requirement. 1 am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. Date. -�o .0 ... . TOWN OF NORTH ANDOVER FO P • - PERMIT FOR GAS INSTALLATION _ C H//U � �9SSASE� This certifies that. ,, - lx C�G !� .�1.." .. ............ has permission for gas installation . in the buildings of.. .0 L.�....`........ .............. . at ....�.... Nor` h Andover, Mass. Fee � :. � Lic. No..13 -2 I �.. `i,... C.J..... -... . GAS INSPECT Check # �2 1// L e / 6468 MASSACHUSETTS UNN ORM APPUCATON FOR PERMU TO DO GAS G (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations S7 Permit # 6 Amount $ Owner's Name 0JUPO — 1-1 New D Renovation D Replacement Plans Submitted (Print or type) Name -�- C%�/� /f G� f��! Check one: Certificate Installing Company (� 13Corp. —a--fS `l Address Partner. usmessI a ep one 7 G Firm/Co. Name of Licensed Plumber�or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance, policy or it's substantial equivalent. yes E3�i No � If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy 0--i Other Type of indemnity D Bond 13 Owner's Insurance Waiver: 1 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 Agent Owner 13 Agent 1 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 installations a ormed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuset t#� Crede and Chapter 142 of the General Laws. i (City/Town:. (APPROVED (OFFICE USE ONLY) mgr fat re°of Licensed Plumber Or Gas Fitt 5 'Ptumber l Gas Fitter Icense um er Master Journeyman Wy a W CO FWF �o� Q O a z V y U w rd x Z F `Sy a O a > FC d W > F F O z d w C C F m F w s O x 3 0 da m > o SU B -BASEMENT i F O B A S E M ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR STH. FLOOR (Print or type) Name -�- C%�/� /f G� f��! Check one: Certificate Installing Company (� 13Corp. —a--fS `l Address Partner. usmessI a ep one 7 G Firm/Co. Name of Licensed Plumber�or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance, policy or it's substantial equivalent. yes E3�i No � If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy 0--i Other Type of indemnity D Bond 13 Owner's Insurance Waiver: 1 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 Agent Owner 13 Agent 1 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 installations a ormed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuset t#� Crede and Chapter 142 of the General Laws. i (City/Town:. (APPROVED (OFFICE USE ONLY) mgr fat re°of Licensed Plumber Or Gas Fitt 5 'Ptumber l Gas Fitter Icense um er Master Journeyman