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HomeMy WebLinkAboutMiscellaneous - 93 WINTERGREEN DRIVE 4/30/2018 (2)a ti Office Use Only elf Ile & III ilia 11tueultlj of M1111fia ljuietto Permit No _ 143 0_ _ kv tic nrtlncnt of Public �rJfct �` v V Occupancy ,& Fee CheckecYu BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date City or Town of /y®• �"�/l��s Ld _ To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. p Location (Street & Number) 73A`3^ Owner or Tenant L761f ✓ iARi Owner's Address -T't Is this permit in conjunction_ with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building __4 - fes T//f-fi Utility Authorization No. Existing Service Jlv Q Amps i�-16/ -2-,,Vs7 Volts Overhead 1�i" Undgrnd No. of Meters New Service Amps _/ Volts Overhead ❑ Undgrnd ❑ No. of Meters U I HER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws 1 have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES — NO _ I have submitted valid proof of same to the Office. YES O NO '` If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE (% BOND C OTHER r' (Please Specify) General Liability 12/31/98 Estimated Value of Electrical Work S _ Work to Start Signed under the Penalties of perjury: FIRM NAM Inspection Date Requested: Rough (Expiration Date) Final / E 1 sonneault ZJ-UULric �t7 LIC. No. A11823 Ucensee LIC. NO. Address d7 Salam Road nraoit Bus. Tel. No. 383 — r�A—_D1826 All. Tel. No. 978 458-9977 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re quired se Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) --_._ Telephone No. (Si _ __ PERMIT FEE S (Signature of Owner or Agent) r -65F5 3 G Date... '6.. ..... ....... ... ... .. ... TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that . ........................ .......... .. ............. .. .......................... has permission to perform- . .. ............ ................................. wiring in the building of. ..... .............................................. at ... North Andover, Mass. Fee........ Lic. No).9-2& ............................................................... ELECTRICAL INSPECTOR 05/13/98 10:46 15-00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer -C-\ Commonwealth of Massachusetts City/Town of - ^ System Pumping Record G„M Svey`., Form 4t DEP has provided this form for use by local Boards of Health. Ot "OWN OF he information must be substantially the same as that provided her Before ch ck with your local Board of Health to determine the form they use. The System Pumping Record must a submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location:eft Eront of hou right front of house, left side of house, right side of house, Left rear of house, right rear o house, left side of building, right rear of building, under deck. City/Town State Zip Code 2. System Owner: Name Address (if different from location) City/Town State `� / Q QZip Code Telephone Number B. Pumping Record -� _ 1. Date of Pumping w ` ` f 2. Quantity Pumped: . Date Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes 9 -90 --" If yes, was it cleaned? ❑ Yes ❑ No 5. Conditiop of System: ,� C�12.1J (1/� V\ 6. System Pumped By: Neil J. Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc. Company 7. Loc n where contents were disposed: G. L. S. D. Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 TOWN OF �J, -LArrEC SYSTEM PUMPING RECORD DATE:1- 5 -001 - SYSTEM OWNER & ADDRESS Aare-ry q3 IA)i✓�jfeev� SYSTEM LOCATION (example: left front of house) DATE OF PUMPING: QUANTITY PUMPED : LIN) N U GALLONS / CESSPOOL: NO YES SEPTIC TANK: NO YES �/ NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: CONTENTS TRANSFERRED TO: (;- Z' - S "6 - TOWN OF NORTH ANDOVER FES 1 9 M SYSTEM PUMPING RECORD DATE: D — 7' ©3 To, Ms-el�,t- Q3 VA J""co�� (example: left front of house) (.4, c kojs-e DATE OF PUMPING: �'? --1-'13 QUANTITY PUMPED �.5GALLONS CESSPOOL: NO I- YES NATURE OF SERVICE: ROUTINE OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER SYSTEM PUMPED BY: COMMENTS: SEPTIC TANK: NO YES EMERGENCY FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) CONTENTS TRANSFERRED TO: �' l_ ` '�;` " YD